A sweeping survey of medical trainees in Japan reveals that future physicians possess a surprisingly limited understanding of diabetes stigma, with many holding onto significant misconceptions despite their clinical education. The study, which polled 921 medical students and residents, found that while awareness of stigma increased with training, it did not necessarily eliminate deep-seated, incorrect beliefs about the disease, suggesting critical gaps in how the next generation of doctors is being prepared to treat one of the world’s most common chronic conditions.

These findings arrive as the global health community increasingly recognizes the damage that stigma—from clinicians and society alike—can inflict on people with diabetes. With diabetes affecting nearly 10% of the world’s adult population, biases from health care providers can undermine trust, impede effective communication, and lead to poorer health outcomes. The new research highlights an urgent need to reform medical curricula to move beyond rote learning and cultivate a more nuanced understanding of the social and psychological burdens carried by patients.

Understanding the Forms of Stigma

Diabetes stigma often manifests as prejudice and negative attitudes, frequently rooted in the misconception that patients are to blame for their condition. This is particularly true for type 2 diabetes, which is commonly associated with obesity, leading to stereotypes that patients are lazy, gluttonous, or non-compliant. Research shows that patients consistently report feeling blamed and shamed not just by family or the media, but also by health care providers themselves.

This external judgment can lead to what experts call internalized stigma, a process where individuals absorb negative societal stereotypes and apply them to themselves. This can diminish self-worth, create feelings of shame, and cause patients to hide their disease or avoid social interactions. Ultimately, these negative experiences can discourage people from seeking necessary medical care or adhering to treatment plans, creating a destructive cycle that worsens their health.

A Survey of Medical Trainees

To gauge how these biases take root in the medical profession, a research team from Kyoto University and St. Marianna University School of Medicine conducted a comprehensive survey between July 2024 and March 2025. They distributed a questionnaire to 921 medical students and residents across various stages of their training, from preclinical studies to clinical practice. The goal was to measure their awareness of both diabetes stigma and patient advocacy efforts for the first time in Japan.

Mixed Levels of Awareness

The results provided a complex picture. A majority of respondents, 57%, reported being aware of diabetes stigma. However, far fewer—only 25.9%—were familiar with advocacy initiatives aimed at combating it. While awareness generally grew as students progressed through their training, the study revealed a troubling counter-trend: a higher proportion of residents, who are actively practicing in hospitals, held certain stigma-related beliefs compared to medical students. This suggests that entering clinical practice without a solid foundation of accurate knowledge may reinforce, rather than correct, harmful biases.

Persistent Misconceptions

Perhaps the most alarming finding was that nearly half of all students and residents surveyed held onto fundamental misconceptions about diabetes. Common falsehoods included the beliefs that “diabetes is always a genetic disease” and “people with diabetes always have a shorter life expectancy.” The persistence of these inaccuracies, even after students had completed clinical lectures on the topic, indicates that standard classroom education may only create a superficial awareness. It fails to dismantle the underlying stereotypes that can negatively influence a physician’s approach to patient care.

The Clinical Consequences of Bias

When physicians harbor biases, the quality of care suffers. Studies show that stigmatizing interactions can feel hurtful and judgmental, causing patients to lose trust in their providers. This perceived bias is a significant barrier to care, as it can induce a physiological stress response that impairs a patient’s ability to communicate effectively or retain new information about their health. Over time, these negative experiences can lead patients to avoid follow-up appointments, a behavior linked to poor outcomes in diabetes management.

The experience of stigma is directly linked to worse health. Patients who report feeling judged are more likely to engage in unhealthy eating behaviors and experience psychological distress, including depressive symptoms. This distress can, in turn, reduce adherence to medication, diet, and exercise regimens, making the disease harder to control and increasing the risk of serious complications like heart disease, neuropathy, and kidney damage.

The Strong Link to Weight Bias

Much of diabetes stigma is intertwined with weight bias. Research conducted at the UConn Rudd Center for Food Policy and Health found that physicians’ biases toward patients with obesity were significant and often transferred to their perceptions of patients with type 2 diabetes. In that study, while 85% of physicians felt confident treating type 2 diabetes, a significant number held deeply negative views: one-third reported being repulsed by these patients, while others viewed them as “lazy” (39%), “lacking motivation” (44%), or “non-compliant” (44%).

Patients are acutely aware of this judgment. Many report feeling that they are not taken seriously by providers, which fosters a sense of distrust and can make them doubt the value of treatment recommendations. This dynamic is especially harmful because it discourages the collaborative, patient-centered relationship needed to manage a complex, lifelong condition like diabetes.

A Call for Educational Reform

Based on their findings, the authors of the Kyoto University study are calling for a comprehensive review of medical education to address diabetes stigma more systematically. They argue that the current gaps in knowledge and the persistence of misconceptions underscore the need for a structured, multi-stage educational framework to foster accurate understanding and empathy. This sentiment is echoed by other researchers in the field, who advocate for new methods to move beyond the textbook.

One promising approach is contact-based education, in which medical students interact directly with panels of patients to hear about their lived experiences with diabetes and stigma. A feasibility study on this method found that a single patient-panel session significantly improved students’ attitudes and reduced their biases. By centering the patient’s voice, such programs can help future physicians develop a deeper sense of empathy and recognize the person behind the diagnosis. Ultimately, experts believe that equipping medical trainees with these tools is essential to creating a world free from diabetes stigma and ensuring all patients receive respectful, unbiased, and effective care.