Parents warned of diabetes stigma in children

Mariecar Jara-Puyod, Senior Reporter

A consultant paediatric diabetologist in the capital has cautioned families and parents of children with diabetes with regard to stigmatisation.

Specifically, Dr Amani Osman of the Imperial College London Diabetes Centre warned parents on the stigma they themselves may bear upon their children suffering from either Type 1 or Type 2 Diabetes (T1D and T2D).

T1D or Juvenile Diabetes is the inability of the pancreas to produce insulin. T2D in children occurs when insulin insufficiently works.

Osman said: “Sometimes, stigmatisation is enforced by the parents themselves. Early on in my career, there was one set of parents who took their child off the insulin pump which I had prescribed because they were concerned about public perceptions.”

She continued: “There are parents who also worry that their child will not be able to get married or have children.”

Osman who had decided to carry on a mission to educate everyone about paediatric diabetes, due to the soaring rates of T2D among children on the global scale, brought up “diabetes stigmatisation,” a study of which was conducted in the US in 2017.

The 2017 study was titled “Stigma in People with Type 1 and Type 2 Diabetes” with lead author Nancy F. Liu.

The authors defined “health-related stigma as a psychological factor known to influence the lives of people with chronic medical conditions.”

They said diabetes stigma “refers to the experiences of negative feelings such as exclusion, rejection, or blame due to the perceived stigmatisation of having diabetes.”

The US study had a total of 5,422 respondents, 1,572 of whom were suffering from T1D and 3,850 with T2D.

It showed that of the 5,422, 81 per cent or 4,392 were perceived by peers and relatives as well as strangers to have a “character flaw or failure of personal responsibility.”

Of the 5,422, 65 per cent of 3,524 were seen as a “burden to the healthcare system.”    

Of the 1,572 T1D, 38 per cent or 597 had experienced that people around them have misconceptions about their conditions such as they have a contagious disease. The situation was at 16 per cent or 616 of the 3,850 T2D.

Of the 3,850 T2D, 25 per cent or 963 strongly agreed that their being seen or observed as diabetics brought about by the necessary medications and lifestyle changes, have  caused them to go through the ambivalence of guilt, shame, blame, embarrassment and isolation. For the 1,572 T1D respondents, this was at 38 per cent or 597, majority of them women at 42 per cent. 

From her own observations, Osman said these conclusions, particularly those relating to “emotional life” are so since diabetes is a “very visible disease with identifiable characteristics” and therefore, everyone with it is easily spotted.

People with diabetes are known by “blood glucose monitoring, insulin injections, dietary restrictions, and hypoglycemic episodes.”

“In younger people, who often feel the pressure to be accepted by peers, these aspects create a sense of ‘otherness.’ It makes it difficult for them to blend in,” Osman said, adding that another negative effect is low self-esteem.

For this matter, she encourages parents to be keener on spotting depression among their children with diabetes as all these impact on mental health.

“This is a problem as these children are already at risk for depression associated with negative diabetes-related health outcomes and complications. They may already be sleeping or eating too much or to little; may lack concentration and may be (acquiring) low grades or even getting in trouble in the school.”

According to the most recent records on diabetes as collected by the International Diabetes Foundation (IDF) in its eighth edition of the “IDF Atlas” in 2017, three per 100,000 children in the UAE between ages zero and 19 are diagnosed every year with T1D. The number of life births affected by hyperglycaemia (condition of excessive amount of sugar or glucose in the bloodstream) in pregnancy (in 1,000) are at 40.

In 2017, over 1.1 million paediatric diabetes were recorded globally and experts said “optimal glycaemic control should be employed as early as possible without affecting the quality of life of the children.”