Associations between diabetes duration and self-stigma development in Japanese people with type 2 diabetes: a secondary analysis of cross-sectional data

Objectives To examine the associations between self-stigma and diabetes duration in a sample of Japanese people with type 2 diabetes.Design A secondary analysis of a cross-sectional study.Setting Two university hospitals, one general hospital and one clinic in Tokyo, Japan.Participants Outpatients w...

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Main Authors: Hideki Hashimoto, Kohjiro Ueki, Toshimasa Yamauchi, Asuka Kato, Yuko Fujimaki, Shin Fujimori, Akihiro Isogawa, Yukiko Onishi, Ryo Suzuki, Takashi Kadowaki
Format: Article
Language:English
Published: BMJ Publishing Group 2021-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/12/e055013.full
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author Hideki Hashimoto
Kohjiro Ueki
Toshimasa Yamauchi
Asuka Kato
Yuko Fujimaki
Shin Fujimori
Akihiro Isogawa
Yukiko Onishi
Ryo Suzuki
Takashi Kadowaki
author_facet Hideki Hashimoto
Kohjiro Ueki
Toshimasa Yamauchi
Asuka Kato
Yuko Fujimaki
Shin Fujimori
Akihiro Isogawa
Yukiko Onishi
Ryo Suzuki
Takashi Kadowaki
author_sort Hideki Hashimoto
collection DOAJ
description Objectives To examine the associations between self-stigma and diabetes duration in a sample of Japanese people with type 2 diabetes.Design A secondary analysis of a cross-sectional study.Setting Two university hospitals, one general hospital and one clinic in Tokyo, Japan.Participants Outpatients with type 2 diabetes aged 20–74 years and receiving treatment from diabetes specialist physicians (n=209) completed a self-administered questionnaire.Primary and secondary outcome measures Self-stigma was measured as the primary outcome. Patient Activation Measure, body mass index and haemoglobin A1c were measured as secondary outcomes.Results One-way analysis of covariance showed significant differences in self-stigma levels between the five groups of diabetes duration (≤5 years, 6–10 years, 11–15 years, 16–21 years and 22 years or more) after controlling for age, gender, education, marital status, diabetes treatment (insulin use) and diabetes-related complications, F(4,198)=2.83, p=0.026. Multiple comparisons using Bonferroni correction showed statistically significant differences in self-stigma levels between the groups with ≤5 years (95% CI 59.63 to 69.73) and 11–15 years with diabetes (95% CI 71.12 to 80.82; p=0.020). The highest mean level of self-stigma was observed in the group having diabetes for 11–15 years.Conclusions Self-stigma was associated with diabetes duration and was lowest after diagnosis and gradually increased, with its highest levels being observed in those having diabetes for 11–15 years. Self-stigma takes time to develop and gradually increases in individuals as it is learnt through direct experiences of diabetes-related stigma after self-administering treatment in everyday social situations.
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spelling doaj-art-33524af9aa5b479094eefe652a2cf9fc2025-08-20T01:54:38ZengBMJ Publishing GroupBMJ Open2044-60552021-12-01111210.1136/bmjopen-2021-055013Associations between diabetes duration and self-stigma development in Japanese people with type 2 diabetes: a secondary analysis of cross-sectional dataHideki Hashimoto0Kohjiro Ueki1Toshimasa Yamauchi2Asuka Kato3Yuko Fujimaki4Shin Fujimori5Akihiro Isogawa6Yukiko Onishi7Ryo Suzuki8Takashi Kadowaki92 Hitachi Social Cooperation Education Research Center, University of Tsukuba Hospital, Hitachi, Ibaraki, JapanDepartment of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanDepartment of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanDepartment of Health and Social Behavior, School of Public Health, The University of Tokyo, Tokyo, JapanDepartment of Internal Medicine, School of Medicine, Teikyo University, Tokyo, JapanDepartment of Internal Medicine, School of Medicine, Teikyo University, Tokyo, JapanDiabetes Care Division, Mitsui Memorial Hospital, Tokyo, JapanDivision of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Tokyo, JapanDepartment of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanHealth Management Center, Toranomon Hospital, Tokyo, JapanObjectives To examine the associations between self-stigma and diabetes duration in a sample of Japanese people with type 2 diabetes.Design A secondary analysis of a cross-sectional study.Setting Two university hospitals, one general hospital and one clinic in Tokyo, Japan.Participants Outpatients with type 2 diabetes aged 20–74 years and receiving treatment from diabetes specialist physicians (n=209) completed a self-administered questionnaire.Primary and secondary outcome measures Self-stigma was measured as the primary outcome. Patient Activation Measure, body mass index and haemoglobin A1c were measured as secondary outcomes.Results One-way analysis of covariance showed significant differences in self-stigma levels between the five groups of diabetes duration (≤5 years, 6–10 years, 11–15 years, 16–21 years and 22 years or more) after controlling for age, gender, education, marital status, diabetes treatment (insulin use) and diabetes-related complications, F(4,198)=2.83, p=0.026. Multiple comparisons using Bonferroni correction showed statistically significant differences in self-stigma levels between the groups with ≤5 years (95% CI 59.63 to 69.73) and 11–15 years with diabetes (95% CI 71.12 to 80.82; p=0.020). The highest mean level of self-stigma was observed in the group having diabetes for 11–15 years.Conclusions Self-stigma was associated with diabetes duration and was lowest after diagnosis and gradually increased, with its highest levels being observed in those having diabetes for 11–15 years. Self-stigma takes time to develop and gradually increases in individuals as it is learnt through direct experiences of diabetes-related stigma after self-administering treatment in everyday social situations.https://bmjopen.bmj.com/content/11/12/e055013.full
spellingShingle Hideki Hashimoto
Kohjiro Ueki
Toshimasa Yamauchi
Asuka Kato
Yuko Fujimaki
Shin Fujimori
Akihiro Isogawa
Yukiko Onishi
Ryo Suzuki
Takashi Kadowaki
Associations between diabetes duration and self-stigma development in Japanese people with type 2 diabetes: a secondary analysis of cross-sectional data
BMJ Open
title Associations between diabetes duration and self-stigma development in Japanese people with type 2 diabetes: a secondary analysis of cross-sectional data
title_full Associations between diabetes duration and self-stigma development in Japanese people with type 2 diabetes: a secondary analysis of cross-sectional data
title_fullStr Associations between diabetes duration and self-stigma development in Japanese people with type 2 diabetes: a secondary analysis of cross-sectional data
title_full_unstemmed Associations between diabetes duration and self-stigma development in Japanese people with type 2 diabetes: a secondary analysis of cross-sectional data
title_short Associations between diabetes duration and self-stigma development in Japanese people with type 2 diabetes: a secondary analysis of cross-sectional data
title_sort associations between diabetes duration and self stigma development in japanese people with type 2 diabetes a secondary analysis of cross sectional data
url https://bmjopen.bmj.com/content/11/12/e055013.full
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