Zoe Lawrence-Haughey – University of Western Australia
Ask anyone with diabetes about shame and stigma, and they will most likely have a story to share. Whether it’s the teacher who takes a sandwich out of your hands and replaces it with a salad, the friend’s boyfriend who jokes about how “Just looking at this burger gave me diabetes!”, or the woman you have never met telling you, “But you’re not that fat…” – no one enjoys being made to feel uncomfortable for something beyond their control. And these stories are just the tip of the iceberg.
Although they may seem farfetched, I have personally experienced one of them, with the other two being shared with me by other people with diabetes (PWD).
National Diabetes week 2021 took place recently, with Diabetes Australia campaigning to end the blame and shame PWD experience in their everyday lives. While there is stigma around the diagnosis itself, there is also a level of shame in treating the condition. Performing fingerpricks to test blood glucose levels, injecting insulin, or wearing medical devices to enable easier management should not be scrutinised. Studies show that mental health is interconnected with diabetes management, and can be impacted by experiencing stigma, potentially leading to worse health outcomes. This is concerning for many reasons, one of which is the fact that both type 1 and type 2 diabetes diagnoses are increasing each year, with a new diagnosis received every five minutes across Australia.
But let’s take a closer look at the individuals in question. As with any diagnosis, there is a vastly diverse community of PWD that lean on one another for support. It may be unexpected to refer to the newest Pixar trailer in a blog post on diabetes, and yet it will raise an important point. Apart from sharing stigma horror stories, another discussion point within the community was the teaser trailer for Pixar’s new film ‘Turning Red’. For around 3 seconds of screen time, a background character is shown to be wearing a white, circular patch on their arm, and when they stand up, a device encased in purple sits on their hip (likely an insulin pump). This is the first time a Pixar character has ever been depicted as living with diabetes, especially a child, although type 1 diabetes is a relatively common autoimmune disease, which is associated with childhood diagnosis. As of writing, Wikipedia listed a whopping 66 films featuring any form of diabetes, across any genre and any language, from 1946 to 2018. Although not the most reputable resource, this number is likely not far from truth, with the majority of movies using diabetes as more of a plot point than a character trait.
Also in the news was a slightly controversial article, which states in the headline the words “finger pricks obsolete”. First of all, this is misleading, the article actually states that finger pricks won’t be ‘obsolete’ for at least another few years. This article described new saliva-based glucose test strips, which is an amazing development, but may fall flat for PWD. The Australian government has provided over $6 million to fund the manufacture of these test strips, while the diabetes community in Australia plead for more funding to be provided towards subsidising continuous glucose monitoring for all Australians living with diabetes. High cost is a significant barrier towards PWD accessing new technology that may drastically improve their life, and so for some, seeing the government fund a distant and somewhat unnecessary glucose test while existing technologies are overlooked may feel like a kick to the pancreas. Furthermore, keeping in line with discussions on stigma, articles like these may propagate the idea that diabetes management is easy, and detract from the struggles actually faced by PWD.
Although a cure may not be here yet, medical advancements and reduced stigma both play important parts in making diabetes more manageable and less stressful. From an outside public health perspective, we often only examine the surface level features of illness, such as the number of people who have it, whether it is preventable or not, and what health outcomes it can lead to. Although there is a long way to go, addressing the ongoing stigma around living with diabetes is an important step in gaining inclusivity and acceptance for all. It is the hope that greater understanding of PWD experiences can also lead to better health outcomes in the future and enable further opportunities for research that may alleviate the challenges faced by PWD.
First published in the CAPHIA newsletter July 2021 – for subscription to the CAPHIA newsletter please email CAPHIA@phaa.net.au
Photo Credit: Diabetes Australia – National Diabetes Week Campaign Resources