Stigmatization of Adults with Type 1 Diabetes in Asia

Abstract

Background: Type 1 diabetes (T1D) is uncommon in Asia. Limited awareness can lead to stigmatization of those with T1D. Aims: We aimed to evaluate diabetes stigma in adults with T1D in Singapore. Methods: This was a cross-sectional sampling of adults with T1D in a tertiary public hospital, using the Type 1 Diabetes Stigma Assessment Scale (DSAS-1). Higher scores indicate greater levels of stigma. Results: 125 Singaporeans (mean age 31.2 ± 11.2 y), T1D duration 13.8 ± 7.3 y, M/F: 51/74, 107 on insulin injections, 18 on insulin pumps were sampled. Item response patterns (Figure) suggest a greater burden of stigma in the blame and judgment and identity concerns subscales. DSAS-1 scores did not differ by gender, treatment regimen, age, education level or employment. Identity concerns subscale scores were lower in those with T1D for >10y (n=73) than those with shorter T1D duration (18.9 ± 5.6 v 21.7 ± 7.3, p=0.045). Total DSAS-1 and subscale scores were similar to those of an Australian (Oz) cohort (n=900) (Sg-v-Oz: Total score 53.1 ± 12.9 vs. 53.0 ± 15.6, Treated differently 13.6 ± 4.0 v 13.6 ± 5.4, Blame and Judgment 19.9 ± 5.2 v 19.9 ± 6.0, and Identity Concerns: 19.6 ± 6.4 v 19.5 ± 7.2, all p>0.05). Conclusion: This is novel data documenting significant levels of diabetes stigma among adults in Singapore, particularly relating to blame and judgment and identity concerns. Despite the low prevalence of T1D in Asia, levels of stigma appeared similar to that of an Australian T1D cohort. Disclosure A.Y.R. Lam: None. D. Gardner: None. S. Rama Chandran: None. E.P. Teo: None. L. Zhu: None. G. Koh: None. S. Goh: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim GmbH, Amgen Inc., Novo Nordisk A/S, Sanofi-Aventis, Servier.