Exploring the correlates of diabetes-related stigma in young and middle-aged adults with type 2 diabetes: A cross-sectional study

Diabetes-related stigma is prevalent among young and middle-aged adults with type 2 diabetes mellitus (T2DM), particularly in Chinese cultural contexts where psychological distress is often somatized. This study aimed to investigate the prevalence of diabetes-related stigma and identify modifiable correlates among working-age adults with T2DM to inform targeted clinical interventions. A total of 180 patients with T2DM aged 18 to 59 years were recruited using stratified sampling based on age, education level, and disease duration. Data were collected using the Chinese version of the type 2 diabetes stigma assessment scale and a sociodemographic questionnaire. Statistical analyses included independent t-tests, 1-way analysis of variance, and hierarchical multiple linear regression. Participants demonstrated moderate-to-high levels of diabetes-related stigma, with the highest scores observed in the blame and judgment dimension (mean item score 3.17 ± 0.44). The total stigma score was 56.14 ± 8.05. Hierarchical regression analysis identified 5 independent predictors of stigma: lower educational level (β = -0.386, P < .001), younger age (18-44 years), lower household income (<3000 RMB/mo), shorter disease duration (<5 years), and multiple comorbidities (≥2 conditions). The regression model explained 38% of the variance in stigma levels (R2 = 0.38, F = 28.066, P < .001). Diabetes-related stigma among young and middle-aged adults with T2DM is moderate to high, particularly in younger, less educated, and financially constrained patients. Healthcare providers should integrate routine stigma assessment into clinical practice and develop tailored interventions addressing age-specific, socioeconomic, and disease-related factors to improve patient outcomes and quality of care.