Summary: In a randomised trial in adults with type 1 diabetes, a brief four-session online educational programme reduced diabetes stigma and improved body image and coping strategies compared with no intervention, with benefits sustained at one-month follow-up.
PICO Summary
| Element | Detail |
|---|---|
| Population | 88 adults with type 1 diabetes (44 intervention, 44 control); randomised clinical trial, Iran. |
| Intervention | Four online educational sessions addressing diabetes stigma, body image, and coping strategies. |
| Comparison | Standard care without the additional educational intervention. |
| Outcome | The intervention group had significantly lower post-test diabetes stigma scores (DSAS-1), lower body-image-distress scores (BIS) at post-test and follow-up, and higher body-image coping scores (BICSI) at post-test and follow-up (all p<0.001). |
Expert Commentary
This is a welcome trial because it treats the psychosocial burden of type 1 diabetes, stigma and body image, as a legitimate therapeutic target rather than an afterthought, and these concerns genuinely matter, since internalised stigma and distress about visible technology or weight changes can impair self-management and quality of life. The results are statistically strong and, encouragingly, persisted to follow-up rather than fading when the sessions ended, suggesting participants retained usable coping skills, and the online format is attractive for reach. I would weigh the design limits the post fairly lists. Convenience sampling may have selected people already motivated around these issues, and crucially the control group received no attention placebo, so part of the benefit could reflect the nonspecific effect of attention and engagement rather than the specific content. The outcomes are self-reported and prone to social-desirability bias, glycaemic measures were not assessed, and the follow-up was short. Can I use this with my patients? Yes, in orientation. It supports screening for stigma and body-image distress and offering scalable psychoeducation, ideally with mental-health collaboration, while I interpret the large effect cautiously given the absence of an active comparator and recognise that psychological gains here were not linked to metabolic outcomes.
References
Jamshidi N, RashtAbadi OR, Ahmadi A, Maghsoudi SH, Rafati F, Yosefzadeh G. Effectiveness of an online educational program on diabetes stigma, body image and body image coping strategies in adults with type 1 diabetes: a randomised clinical trial. Int J Nurs Pract. 2026;32(1):e70098. doi:10.1111/ijn.70098