Nagaaki Tanaka

INTRODUCTION Diabetes mellitus is an increasing global health threat.1 Advances in diabetes self-management techniques have generally facilitated achieving glycemic targets for people with diabetes (PWD); however, stigma has been reported to be associated with reduced self-care behaviors, psychological distress, and suboptimal clinical outcomes, which may limit these benefits.

1 INTRODUCTION Diabetes is a chronic disease that affects millions of individuals worldwide, requiring long-term treatment and self-management (International Diabetes Federation, 2025). The physical demands of prolonged treatment and self-care can be substantial, and individuals with diabetes often bear the psychological burden of stigma (Eitel et al., 2024).