Abstract
Type 2 diabetes affects racial/ethnic minorities at an alarming rate in the US and in many countries around the world. The quality of health care provided to these groups is often suboptimal, resulting in worse patient-related outcomes when compared to those in mainstream populations. Understanding the complex biological elements that influence the development and course of the disease in high-risk populations is extremely important but often insufficient to implement effective prevention and treatment plans. Multiple factors must be addressed in routine diabetes clinical care. This paper discusses various key factors, organized in alphabetical order. These are acculturation, biology, clinician's cultural awareness, depression and diabetes-specific emotional distress, educational level, fears, group integration, health literacy, intimacy and sexual dysfunction, judging, knowledge of the disease, language, medication adherence, nutritional preferences, other forms of medicine (alternative), perception of body image, quality of life, religion and faith, socio-economic status, technology, unconscious bias, vulnerable groups, asking why?, exercise, “you are in charge” and zip it! Considering these factors in the development of type 2 diabetes prevention and treatment programs will help improve diabetes-related outcomes in culturally diverse populations and reduce health care disparities.
Highlights
Modern societies around the world are integrated by culturally diverse populations and health care professionals frequently face the challenge of providing care to a wide variety of patients
Perhaps we have focused too much on the medical/biological aspects of the disease and we have not fully addressed educational, Type 2 Diabetes in Racial/Ethnic Minorities social, financial, psychological and cultural determinants of health and disease when designing prevention and treatment programs for our patients
Whereas overall obesity rates are usually higher in some racial/ethnic minorities in comparison to whites, African-Americans have been identified with lower visceral fat content than non-Hispanic whites with similar body mass index (BMI) [32]
Summary
Modern societies around the world are integrated by culturally diverse populations and health care professionals frequently face the challenge of providing care to a wide variety of patients. The management of diabetes and other chronic diseases can be difficult since multiple biological, social, psychological and cultural factors play a role in the development and progression of these conditions. Health care providers often have limited awareness of how these factors must be addressed in clinical practice, in our current environment when very limited time to interact with patients is available during clinical encounters. Few health care settings have truly embraced the development and implementation of effective culturally oriented programs that make people from different populations feel they are truly heard and understood. Perhaps we have focused too much on the medical/biological aspects of the disease and we have not fully addressed educational, Type 2 Diabetes in Racial/Ethnic Minorities social, financial, psychological and cultural determinants of health and disease when designing prevention and treatment programs for our patients. There is no particular order of importance—I believe they all are important!
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