Disparities in diabetes mellitus among Caribbean populations: a scoping review

Abstract

BackgroundDespite the large body of research on racial/ethnic disparities in health, there are limited data on health disparities in Caribbean origin populations. This review aims to analyze and synthesize published literature on the disparities in diabetes mellitus (DM) and its complications among Afro-Caribbean populations.MethodsA detailed protocol, including a comprehensive search strategy, was developed and used to identify potentially relevant studies. Identified studies were then screened for eligibility using pre-specified inclusion and exclusion criteria. An extraction form was developed to chart data and collate study characteristics including methods and main findings. Charted information was tagged by disparity indicators and thematic analysis performed. Disparity indicators evaluated include ethnicity, sex, age, socioeconomic status, disability and geographic location. Gaps in the literature were identified and extrapolated into a gap map.ResultsA total of 1009 diabetes related articles/manuscripts, published between 1972 and 2013, were identified and screened. Forty-three studies met inclusion criteria for detailed analysis. Most studies were conducted in the United Kingdom, Trinidad and Tobago and Jamaica, and used a cross-sectional study design. Overall, studies reported a higher prevalence of DM among Caribbean Blacks compared to West African Blacks and Caucasians but lower when compared to South Asian origin groups. Morbidity from diabetes-related complications was highest in persons with low socioeconomic status. Gap analysis showed limited research data reporting diabetes incidence by sex and socioeconomic status. No published literature was found on disability status or sexual orientation as it relates to diabetes burden or complications. Prevalence and morbidity were the most frequently reported outcomes.ConclusionLiterature on diabetes health disparities in Caribbean origin populations is limited. Future research should address these knowledge gaps and develop approaches to reduce them.

Obesity and the food system transformation inLatin America

“…In the Latin America and the Caribbean (LAC), extensive child and adult obesity, poor diets and inadequate physical activity are causing high levels of diabetes, hypertension and other noncommunicable diseases (NCDs) (1)(2)(3)(4)(5). At the same time, large proportions of the children in many nations in the region are malnourished and stunted from poor feeding during the first 1,000 d of their lives (6)(7)(8).…”

Serum Vitamin D and Age-Related Muscle Loss in Afro-Caribbean Men: The Importance of Age and Diabetic Status

“…Although low vitamin D level has often been associated with increased risk of insulin resistance and diabetes mellitus (9), the Afro-Caribbean populations have, paradoxically, high burden of diabetes mellitus (DM), possibly due, in part, to different characteristics of skeletal muscle, such as different rate of muscular fat infiltration and/or distinct composition of muscle fibers (10–12). Because DM may further exacerbate muscle loss in older adults (13), this population may be at higher risk of age-related muscle loss.…”

Social support and diabetes self-management behavior among Caribbean, Caribbean American, and African American women: A descriptive correlation study

“…[10] The average prevalence of T2D is estimated to be approximately 9% in the Caribbean countries. [11,12] Similar to the African American population in the United States, the Black Caribbeans in the United States Virgin Islands (USVI) are more likely to have diabetes than their counterparts in other Caribbean islands. [12][13][14][15][16] Besides the high prevalence of T2D among African Americans and Black Caribbeans, this population also confronts similar complications, such as low health literacy, health beliefs, and accessibility of culturally sensitive information, all impediments which make it difficult to render proper care.…”