Improving type 2 diabetes care and self‐management at the individual level by incorporating social determinants of health

Frier, Amanda; Devine, Sue; Barnett, Fiona; McBain‐Rigg, Kris; Dunning, Trisha

doi:10.1111/1753-6405.13296

Cited by 2 publications

(2 citation statements)

References 18 publications

(37 reference statements)

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“…16,17 Current research in other contexts have shown the importance of taking a socioecological approach to T2DM education and self-management programs. [18][19][20] The participants with a self-reported diagnosis of T2DM had elevated DBP and SBP levels, an elevated pulse pressure, and elevated triglycerides compared to the participants without a self-reported diagnosis of T2DM. These findings indicate an elevated risk for cardiac impairment and heart disease in those with T2DM, amplifying the risk of diabetic complications.…”

Section: Discussionmentioning

confidence: 99%

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Health Profiles of Marshallese With and Without a Type 2 Diabetes Diagnosis in the Republic of the Marshall Islands

Andersen,

Felix,

Malhis

et al. 2023

Clin Med Insights Endocrinol Diabetes

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Background: The Republic of the Marshall Islands (RMI) faces a high prevalence of type 2 diabetes (T2DM). Objectives: The aim of the study is to document the health of Marshallese with and without a T2DM diagnosis to inform future interventions. Design: Data are from screenings collected in preparation for a diabetes education intervention. Data, including HbA1c, random glucose, cholesterol, weight, and self-rated health, were collected. Methods: Kruskal-Wallis and Fisher’s exact tests were used to identify differences in participants with and without T2DM diagnosis. Results: There were significant differences in both HbA1c level ( P ⩽ .0001) and glucose level ( P ⩽ .0001) between the diagnosed T2DM and non-diagnosed T2DM groups, as well as diastolic blood pressure ( P = .0179), systolic blood pressure ( P = .0003), and pulse pressure ( P = .0023). There were no differences in weight, body mass index (BMI), high density lipoprotein (HDL), low density lipoprotein (LDL), total cholesterol, or self-rated health. Marshallese without a T2DM diagnosis have signs of insulin resistance, including elevated glucose and triglyceride levels. Conclusion: The results indicate a need for a socioecological approach to T2DM interventions, and interventions in the RMI should consider inclusion of blood pressure and cholesterol management. There is a need for interventions to prevent prediabetes and its progression to T2DM.

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Section: Discussionmentioning

confidence: 99%

“… 16 , 17 Current research in other contexts have shown the importance of taking a socioecological approach to T2DM education and self-management programs. 18 – 20 …”

Section: Discussionmentioning

confidence: 99%

Health Profiles of Marshallese With and Without a Type 2 Diabetes Diagnosis in the Republic of the Marshall Islands

Andersen,

Felix,

Malhis

et al. 2023

Clin Med Insights Endocrinol Diabetes

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Structural Racism as an Upstream Social Determinant of Diabetes Outcomes: A Scoping Review

et al. 2023

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OBJECTIVE To evaluate the evidence on the role of structural racism as an upstream factor impacting diabetes outcomes, identify current gaps, and recommend areas for future work. RESEARCH DESIGN AND METHODS A reproducible search of Medline and Ovid was used. Structural factors based on the World Health Organization social determinants of health framework (governance, macroeconomic policy, social policy, public policy, and cultural and societal values) had to be included as measured variables or contextual factors discussed as upstream influences. Outcomes included 1) hemoglobin A1c (HbA1c), 2) LDL, 3) BMI, 4) quality of life, 5) self-efficacy, 6) mortality, 7) years of life lost, and 8) self-care behaviors. RESULTS Thirteen articles were included for final synthesis. Ten studies focused on governance, two on social policies, one on public policies, and one on cultural and societal values. Results highlight significant associations between structural racism and poorer clinical outcomes (HbA1c and blood pressure), worse self-care behaviors (diet and physical activity), lower standards of care, higher mortality, and more years of life lost for adults with diabetes. CONCLUSIONS There is a paucity of work investigating the relationship between structural racism and diabetes outcomes. Five areas for future work include 1) more rigorous research on the relationship between structural racism, downstream social determinants, and health outcomes in diabetes, 2) policy assessments specific to diabetes outcomes, 3) research designed to examine pathways and mechanisms of influence, 4) intervention development to mitigate the impact of structural racism, and 5) tracking and monitoring of change over time.

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Improving type 2 diabetes care and self‐management at the individual level by incorporating social determinants of health

Cited by 2 publications

References 18 publications

Health Profiles of Marshallese With and Without a Type 2 Diabetes Diagnosis in the Republic of the Marshall Islands

Health Profiles of Marshallese With and Without a Type 2 Diabetes Diagnosis in the Republic of the Marshall Islands

Structural Racism as an Upstream Social Determinant of Diabetes Outcomes: A Scoping Review

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