Diabetes-Related Stigma and Associated Factors in Jazan, Kingdom of Saudi Arabia

Background : Diabetes-related stigma (DRS) is a psychosocial strain that interferes with self-management routines, emotional health, and glycemic control in people with type 2 diabetes (T2D). In the Kingdom of Saudi Arabia, where the prevalence of diabetes is high, the specific social and clinical factors that influence DRS remain poorly researched. Therefore, this study sought to explore the sociodemographic and clinical factors associated with DRS in T2D patients in Saudi Arabia. Methods : We conducted a cross-sectional survey of 321 patients with T2D who visited the Endocrinology and Diabetes Center in Jazan, Saudi Arabia, from May to October 2024. Information was gathered using structured questionnaires that documented sociodemographic and clinical characteristics as well as scores from the Diabetes Stigma Assessment Scale (DSAS-2). Hierarchical linear regressions were used to evaluate how sociodemographic and clinical factors contributed to the explanation of DSAS-2 scores. Results: The mean age was 52.2 ± 16.1 years and the mean HbA1c was 9.3 ± 2.3%. DRS was significantly and positively associated with HbA1c (β = 0.41, p < 0.001), BMI (β = 0.17, p < 0.001), and hypoglycemic episodes per year (β = 0.25, p < 0.001), whereas the number of insulin injections per day was negatively associated with DRS (β = –0.17, p < 0.05). Being unmarried (β = 0.28, p < 0.001), older age (β = 0.26, p < 0.01), and higher education (β = 0.21, p < 0.05) were also significantly associated with increased DRS. The final regression models explained 32.7% of the variance in the overall DSAS-2 score. Conclusion: DRS is an important concern among individuals with T2D in Saudi Arabia and is associated with a combination of clinical and sociodemographic factors. These findings highlight the need to integrate stigma reduction into diabetes care, and call for further research to examine causal pathways and inform culturally sensitive interventions.