de Lucca Milena, Visser Megan, André Tatiane Geralda, Namoc Leturia Sisi, Nascimento Lucila Castanheira, Barber Rebecca Ortiz La Banca
College of Nursing, University of São Paulo at Ribeirão Preto, São Paulo 05508-220, Brazil.
Institute for Nursing and Interprofessional Research, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA.
Children (Basel). 2025 Jul 3;12(7):882. doi: 10.3390/children12070882.
Effective diabetes self-management is critical for glycemic management and well-being, yet Latino youth face unique cultural and socioeconomic barriers that are insufficiently explored in the literature. This review mapped existing evidence on diabetes self-management for Latino youth. Searches were conducted in PubMed, CINAHL, SCOPUS, Web of Science, LILACS, ERIC, and The Cochrane Library, using the gray literature and reference lists, in September 2024, following JBI guidelines. The included studies were qualitative, quantitative, and mixed-methods studies and reviews on diabetes self-management for Latinos aged 0-30 with type 1 or 2 diabetes. Studies including participants over 30 or with gestational diabetes were excluded. Two reviewers independently extracted data using a standardized table and analyzed findings using the Association of Diabetes Care & Education Specialists framework (ADCES7) for self-care behaviors: healthy eating, being active, monitoring, taking medication, problem-solving, reducing risks, and healthy coping. Forty-five studies (forty from the United States) were included from 860 citations. The findings highlighted challenges in adopting diabetes-friendly diets, including cultural preferences, food insecurity, and limited resources. Physical activity improved glycemic control but was hindered by family and school obligations. Continuous glucose monitoring (CGM) enhanced outcomes, though economic barriers limited access. Family-centered education improved medication adherence, while family support strengthened problem-solving. CGMs and insulin pumps reduced complications, and culturally adapted psychological support enhanced emotional well-being and glycemic management. This review underscores persistent disparities in diabetes self-management among Latino youth. While the study designs and settings were heterogeneous, the findings highlight the need for culturally tailored, family-centered interventions that address structural barriers and psychosocial needs to improve care.
有效的糖尿病自我管理对于血糖控制和健康至关重要,但拉丁裔青少年面临独特的文化和社会经济障碍,而这些障碍在文献中尚未得到充分探讨。本综述梳理了关于拉丁裔青少年糖尿病自我管理的现有证据。2024年9月,按照循证卫生保健国际协作网(JBI)指南,在PubMed、护理学与健康领域数据库(CINAHL)、Scopus数据库、科学引文索引(Web of Science)、拉丁美洲及加勒比地区卫生科学数据库(LILACS)、教育资源信息中心(ERIC)和考克兰图书馆中进行检索,并利用灰色文献和参考文献列表。纳入的研究包括定性研究、定量研究、混合方法研究以及关于1型或2型糖尿病的0至30岁拉丁裔糖尿病自我管理的综述。排除了包括30岁以上参与者或患有妊娠糖尿病的研究。两名评审员使用标准化表格独立提取数据,并使用糖尿病护理与教育专家协会框架(ADCES7)对自我护理行为进行分析:健康饮食、积极运动、监测、服药、解决问题、降低风险和健康应对。从860篇文献中纳入了45项研究(40项来自美国)。研究结果突出了采用有利于糖尿病的饮食方面的挑战,包括文化偏好、粮食不安全和资源有限。体育活动改善了血糖控制,但受到家庭和学校义务的阻碍。持续葡萄糖监测(CGM)改善了治疗效果,尽管经济障碍限制了其使用。以家庭为中心的教育提高了药物依从性,而家庭支持增强了问题解决能力。CGM和胰岛素泵减少了并发症,并且经过文化调适的心理支持提高了情绪健康水平和血糖管理能力。本综述强调了拉丁裔青少年在糖尿病自我管理方面持续存在的差异。虽然研究设计和背景各不相同,但研究结果凸显了需要开展针对文化特点、以家庭为中心的干预措施,以解决结构性障碍和心理社会需求,从而改善护理。