Could Once-Weekly Insulin Help Reduce Diabetes Stigma?

Diabetes stigma refers to the negative beliefs and misconceptions about diabetes. People with diabetes might experience different types of stigma – including judgment for taking insulin. Insulin is mistakenly thought to be necessary only for type 1 diabetes, but it is a medication that can be beneficial for all types of diabetes.

There are different types of insulin that have different roles for blood sugar management. New insulins, including once-weekly insulin (which is available in some countries but not yet in the U.S.), are being studied in clinical trials and have been shown to reduce the number of insulin injections needed to achieve similar target blood sugar goals. Finding the right insulin therapy can increase medication-taking behavior, which can lead to improved health outcomes for people living with diabetes. 

With new therapies comes an additional need to broadly educate people on the use of insulin to treat all types of diabetes. Advancements in insulin can help reduce the burden of diabetes management, leading to greater autonomy over how someone chooses to treat their health. Feeling empowered in diabetes care can also help people with diabetes become more resilient to diabetes stigma. 

What is diabetes stigma?

Diabetes stigma refers to the negative social judgment, prejudice, and discrimination against someone with diabetes. This stigma is often rooted in the misconception that an unhealthy lifestyle leads to diabetes, blaming an individual for the condition. In reality, all types of diabetes are complex conditions with many causes and risk factors. 

About four in five adults with diabetes report experiencing stigma. This can include internalized and experienced stigma. Internalized stigma is the negative view of oneself and their condition. An example of internalized stigma includes blaming yourself for having diabetes, which can lead to feelings of shame and a lower self-worth. 

Experienced stigma is external, and includes others’ attitudes, comments, and behaviours towards someone with diabetes. An example of externalized stigma includes being told you can’t eat something because you have diabetes or being asked to manage your diabetes in private because it makes others feel “uncomfortable.” 

Both internalized and experienced stigma can lead to negative health outcomes, including decreased medication-taking behavior, higher A1C, lower self-esteem, loneliness, and increased risk for disordered eating.

What is insulin stigma?

Insulin stigma refers to the negative attitudes toward taking insulin, often driven by the false idea that insulin use indicates a more severe form of diabetes or a personal failure to manage diabetes. 

Insulin stigma may also include fears of being mistaken for using recreational drugs, which can lead some individuals to avoid taking insulin in public or skip injections altogether. This stigma can also lead people with type 2 or gestational diabetes to avoid insulin despite its benefits, and can result in others taking pity on someone living with diabetes. This misplaced pity fails to acknowledge why someone might need insulin. 

People with type 1 diabetes cannot make insulin and need to take insulin to live. People with type 2 diabetes cannot make enough insulin, or their body cannot use it efficiently. While there are several treatments to manage type 2 diabetes, such as behavior changes and medications like metformin or GLP-1 receptor agonists, for some people, insulin therapy may also be beneficial and necessary. 

People with type 2 diabetes who take insulin have a higher perceived stigma compared to those who take oral diabetes medications. 

“For those with type 2 diabetes, we see an extra layer of stigma surrounding insulin as a marker of condition severity,” said Dr. Elizabeth Holmes-Truscott, deputy director at The Australian Centre for Behavioural Research in Diabetes. 

She shared how a lack of positive visibility in how insulin use can help treat type 2 diabetes has led to feelings of moralistic judgment of how their condition has been managed. Many factors can affect blood sugar levels, and it can be challenging for one person to manage all of these factors at the same time, at all times. 

What is once-weekly insulin?

There are different types of insulin that have fast-acting or long-acting properties. Both types of insulin can be helpful for managing diabetes. New on the horizon is once-weekly insulin, a long-acting (basal) insulin that has the potential to dramatically reduce the number of injections needed for people with type 2 diabetes. Currently, there are no FDA-approved once-weekly insulins. However, there are two once-weekly insulins that have shown promising clinical trial data: Lilly’s insulin efsitora and Novo Nordisk’s insulin icodec. 

Multiple clinical trials on insulin efsitora with nearly 4,000 people with type 2 diabetes have been completed. The data showed that efsitora was as effective as daily basal insulin and increased time in range for people with type 2 diabetes. 

Insulin icodec (Awiqli brand name) is a once-weekly insulin that was resubmitted for FDA approval in September 2025. Icodec has been shown to be as effective as once-daily insulin in reducing A1C for people with type 2 diabetes. Currently, icodec is approved in Europe, Canada, Australia, Japan, and Switzerland for type 1 and type 2 diabetes, and in China for type 2 diabetes. 

How once-weekly insulin could help with diabetes stigma

There are perceived burdens tied to insulin therapy, including the fear that taking insulin might affect someone’s ability to socialize, work, or travel. Especially when it comes to multiple daily injections, insulin is often taken in public and can draw attention – this visibility is often what subjects a person to stigma.

“A weekly insulin dose is more discreet, potentially enabling an avoidance of public administration that could put someone at risk of experiencing stigma. This gives people with diabetes more choice about when and how they share their diabetes diagnosis and its treatment with others,” said Holmes-Truscott.

Starting insulin therapy can be intimidating and requires adjustments to daily life. By reducing the number of annual insulin injections from 365 to 52, once-weekly insulin can increase medication-taking behavior and improve acceptance of insulin therapy. By reducing the burden of therapy, there can be an increased sense of autonomy over a person’s health. 

The future of insulin stigma

Insulin stigma is rooted in misinformation and a lack of understanding around insulin therapy. To address diabetes stigma, a joint effort to educate both people with and without diabetes is needed. To help eliminate the stigma associated with insulin use, there is also a need to change the way healthcare providers are trained, added Holmes-Truscott. 

“Most clinicians, whether they are diabetes specialists or not, will encounter people with diabetes,” said Holmes-Truscott. “Improved professional development around empathic care is critical to addressing health stigma more broadly.” 

Physicians who use motivational interviewing, which involves a person-centered approach to care, had more positive perceptions of people with type 2 diabetes and less stigmatizing attitudes. 

A general understanding of how diabetes occurs could reduce the blame and shame placed on people with diabetes. A shift towards destigmatizing language can help humanize and highlight the reality of living with diabetes. Community-led initiatives, including diaTribe’s dStigmatize effort, emphasize the power of language as a tool to be more inclusive and person-centered. This might look like switching the term “diabetic” to “person with diabetes,” which shows that a person is more than their diagnosis. 

Holmes-Truscott also called on all individuals and organizations to take the Pledge to End Diabetes Stigma. diaTribe is proud to have signed the Pledge and support the upcoming world’s first Global Summit to End Diabetes Stigma, to be held in Jaipur, India March 2026.

The bottom line

Insulin stigma is rooted in misinformation and can have negative health outcomes for people living with diabetes. There is a particular lack of positive visibility in insulin use to treat type 2 diabetes. 

Advancements in therapy, like once-weekly insulin, could help reduce the burden of blood sugar management and improve acceptance of a diabetes diagnosis. A joint effort to educate both people with and without diabetes is needed to counter the stigma around insulin use. 

Learn more about diabetes, stigma, and insulin therapy here:

• Getting Started with Insulin if You Have Type 2 Diabetes
• 5 Tips for Easier Insulin Injections
• Stigma Makes Managing Diabetes Harder

This content was made possible with support from Eli Lilly and Company. Sponsored articles are independently written by diaTribe and are subject to our standard editorial and medical review process to ensure they meet our standards for quality, accuracy, and relevancy. Final editorial authority rests with diaTribe.