Background
Despite being largely preventable, the prevalence of Type 2 diabetes mellitus (T2D) is increasing rapidly in low- and middle-income countries, including India. Beyond biomedical risk factors, psychosocial elements such as disease knowledge and stigma play an important role in shaping treatment-seeking and social inclusion. However, limited evidence exists on how diabetes knowledge and stigma intersect within the Indian context.

Objective
This study aimed to examine the relationship between diabetes knowledge and multidimensional diabetes stigma among urban Indian adults.

Methods
A cross-sectional online survey was conducted among 210 adults (mean age = 31.33 ± 12.27, 74 females) in urban India. Participants completed validated measures of diabetes knowledge and diabetes-related stigma. Associations between knowledge, stigma dimensions, and sociodemographic variables were examined using correlation analyses, independent samples t-tests, and linear regression models.

Results
Higher diabetes knowledge was associated with greater stereotype-based and negative-attitude stigma. Familiarity with diabetes through a blood relative predicted higher knowledge and reduced social-distance stigma. Gender differences were observed, with men reporting higher social-distance stigma and women endorsing higher attitudinal and stereotype-based stigma.

Conclusion
Diabetes stigma in India is a multidimensional phenomenon shaped by knowledge, familiarity, and gendered social norms. While awareness and familial exposure may reduce interpersonal avoidance, they may simultaneously reinforce moralised and blame-oriented stigma. Stigma-reduction efforts should therefore move beyond information-based approaches to address structural, moral, and gendered dimensions of T2D stigma.