Diabetes-Related Stigma in Individuals with Type 2 Diabetes: An Explanatory Sequential Mixed-Methods Study

PURPOSE: This study aims to identify the extent of the stigma experienced by patients with type 2 diabetes, determine its associated predictors, and explore the patients' experiences. DESIGN: An explanatory sequential mixed-methods design was employed. METHODS: A cross-sectional design was employed in the quantitative phase; subsequently, in the qualitative phase, interviews were conducted using a phenomenological approach. Quantitative data were analyzed using independent-samples t-tests, one-way analysis of variance, and hierarchical regression analysis, while qualitative data were analyzed using content analysis. FINDINGS: In the multiple regression analysis of the quantitative findings, it was determined that education level (β = 0.169, p < 0.001), duration of diabetes diagnosis (β = -0.094, p = 0.033), history of diabetes-related complications (β = -0.197, p < 0.001), HbA1c level (β = 0.381, p < 0.001), and age (β = -0.309, p < 0.001) were statistically significant predictors of the participants' levels of stigmatization (p < 0.001). Qualitative findings were organized into four main themes: (1) sources of stigma, (2) emotional burnout and feelings of exclusion, (3) social life with diabetes, and (4) coping and support mechanisms. CONCLUSION: Stigmatization in patients with diabetes is associated with clinical findings, younger age, a higher level of education, and diabetes-related complications; it can stem from various sources and lead to emotional distress, a sense of exclusion, and social isolation. CLINICAL RELEVANCE: By recognizing the risk of stigmatization, nurses can provide guidance in the planning and implementation of intervention programs tailored to the patient's social context, as well as in the delivery of education and counseling services.