The Effect of Perceived Stigma on Treatment Adherence and Information Avoidance in People with Type 1 and Type 2 Diabetes

Joelle Dorsett

Authors:  Joelle Dorsett, Rachel Forsyth, James Shepperd

Faculty Mentor:  James Shepperd

College:  College of Medicine


Diabetes requires strict adherence to a treatment regimen to prevent adverse health outcomes. However, many people with diabetes fail to fully adhere to their treatment, and some may avoid information about how well they are managing their diabetes. In addition, Type 2 diabetes is often stigmatized because it is viewed as a lifestyle choice. We examined whether Type 2 diabetes corresponds with greater stigma, lower adherence, and greater monitoring avoidance than Type 1 diabetes. In a cross-sectional study of volunteers (N = 287) recruited through ResearchMatch, we found that people with Type 2 diabetes were less likely to adhere to their treatment and more likely to avoid diabetes management information than people with Type 1 diabetes. Across both types of diabetes, people with greater internalizing stigma were less likely to adhere to their treatment and more likely to avoid diabetes management information. Identifying a link between stigma, diabetes treatment adherence, and diabetes information avoidance suggests possible interventions to increase adherence, decrease information avoidance, and improve glycemic control.

Poster Pitch

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8 Responses
  1. Sarah Peeling

    Hi Joelle,
    This was really interesting, great job! What future directions do you see for this research?

    1. Joelle Dorsett

      Hi Sarah,

      Thank you! In the future, I would love to further explore the impact of weight stigma on treatment adherence and information avoidance in people with diabetes. Specifically, I would be interested in exploring just how much of perceived diabetes stigma (particularly in people with Type 2 diabetes) can be traced to weight stigma. I would also love to explore the role of physicians in perpertuating feelings of stigma, especially among racial minorities with diabetes.

  2. Hunter Shaw

    Hi Joelle! I really love what you did with this research, I think that too often we see healthcare barriers as a singular issue surrounding access, but it’s extremely important to consider how even with access to proper treatment, stigma and perception can negatively impact patients.

    1. Joelle Dorsett

      Hi Hunter,

      Thank you! You raise an interesting point. Even when treatment is accessible, stigma can discourage people from seeking it.

  3. Hunter Shaw

    Hi Joelle! I really appreciate the research that you did on this topic. I feel that too often healthcare barriers are seen as a singular issue surrounding access. But you did a great job of showing how even with proper access to treatment, perception can hold back those that need treatment most from getting it. I hope you keep this research up in the future, it seems as though it could be extremely applicable going forward and could steer the healthcare system in the proper direction of seeing mental health as just as important as physical health.

  4. Joelle Dorsett

    Hi Hunter,

    You raise another great point! Not only is mental health just as important as physical health, the two are quite intertwined. Thank you for your thoughts and encouragement!

  5. Michelle Castro

    Hi Joelle,

    I loved your poster! There are a lot of barriers (medication costs, low health literacy) that we can think of when talking about what keeps people from adhering to treatments but it was refreshing to hear about the effect that stigma can have as well. Understanding this barrier more could be a great addition to how we currently explain treatment to patients.

    1. Joelle Dorsett

      Thank you, Michelle! You are very right! I think that how we currently explain treatment adherence to patients needs to change, and I think that encouraging physicians to be more mindful of stigma and their own biases may be key. But that’s a topic for future research!