Department of Medicine, Emory University, Atlanta, GA, USA; Emory Global Diabetes Research Center, Emory University, Atlanta, GA, USA; Hubert Department of Global Health, Rollins School of Public Health, Atlanta, GA, USA.
Emory Global Diabetes Research Center, Emory University, Atlanta, GA, USA; Hubert Department of Global Health, Rollins School of Public Health, Atlanta, GA, USA.
Lancet Diabetes Endocrinol. 2023 Jul;11(7):509-524. doi: 10.1016/S2213-8587(23)00129-8. Epub 2023 Jun 22.
Type 2 diabetes disparities in the USA persist in both the prevalence of disease and diabetes-related complications. We conducted a literature review related to diabetes prevention, management, and complications across racial and ethnic groups in the USA. The objective of this review is to summarise the current understanding of diabetes disparities by examining differences between and within racial and ethnic groups and among young people (aged <18 years). We also examine the pathophysiology of diabetes as it relates to race and ethnic differences. We use a conceptual framework built on the socioecological model to categorise the causes of diabetes disparities across the lifespan looking at factors in five domains of health behaviours and social norms, public awareness, structural racism, economic development, and access to high-quality care. The range of disparities in diabetes prevalence and management in the USA calls for a community-engaged and multidisciplinary approach that must involve community partners, researchers, practitioners, health system administrators, and policy makers. We offer recommendations for each of these groups to help to promote equity in diabetes prevention and care in the USA.
美国 2 型糖尿病的发病差异不仅存在于疾病的流行率，也存在于糖尿病相关并发症方面。我们对美国不同种族和族裔群体的糖尿病预防、管理和并发症相关文献进行了综述。本综述的目的是通过检查不同种族和族裔群体之间以及不同年龄（<18 岁）人群之间的差异，总结目前对糖尿病发病差异的理解。我们还研究了与种族和族裔差异相关的糖尿病发病的病理生理学。我们使用一个基于社会生态模型的概念框架，对整个生命周期中导致糖尿病发病差异的因素进行分类，着眼于健康行为和社会规范、公众意识、结构性种族主义、经济发展和获得高质量医疗保健这五个领域的因素。美国在糖尿病发病率和管理方面的差异范围需要采取一种以社区为基础和多学科的方法，必须涉及社区合作伙伴、研究人员、从业者、医疗体系管理者和政策制定者。我们为这些群体中的每一个都提出了建议，以帮助促进美国在糖尿病预防和护理方面的公平。
