Norris Quintin, Brandt Mckenzie D, Nagy Stephanie, Kesselman Marc, Demory Michelle L
Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA.
College of Medicine, University of Central Florida, Orlando, FL, USA.
J Racial Ethn Health Disparities. 2025 Sep 19. doi: 10.1007/s40615-025-02668-3.
American Indian and Alaska Native (AI/AN) populations face a disproportionately high prevalence of type 2 diabetes mellitus (T2DM) compared to other U.S. racial and ethnic groups. Despite this burden, limited literature exists on effective, culturally sensitive interventions, highlighting a critical need for focused research in this population. This systematic review examines 28 studies on how self-management, clinical management, and community-based programs improve glycemic control, medication adherence, and patient engagement in AI/AN populations. Clinical management reveals widespread use of metformin but limited initiation of newer agents such as Sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists. Interventions integrating traditional practices and community engagement consistently yielded better diabetes outcomes. Effective T2DM management in AI/AN populations depends on culturally sensitive, community-based approaches that enhance adherence and clinical outcomes. While clinical care evolves, incorporating culturally grounded strategies alongside optimized pharmacotherapy is essential. Future efforts should focus on integrated care models that respect cultural values and support long-term management to reduce diabetes disparities.
与美国其他种族和族裔群体相比，美国印第安人和阿拉斯加原住民（AI/AN）人群中2型糖尿病（T2DM）的患病率极高。尽管有这种负担，但关于有效且具有文化敏感性的干预措施的文献有限，这凸显了对该人群进行重点研究的迫切需求。本系统综述考察了28项关于自我管理、临床管理和基于社区的项目如何改善AI/AN人群血糖控制、药物依从性和患者参与度的研究。临床管理显示二甲双胍被广泛使用，但钠-葡萄糖协同转运蛋白-2（SGLT2）抑制剂和胰高血糖素样肽-1（GLP-1）受体激动剂等新型药物的起始使用有限。将传统做法与社区参与相结合的干预措施始终能产生更好的糖尿病治疗效果。AI/AN人群中有效的T2DM管理依赖于具有文化敏感性的、基于社区的方法，这些方法可提高依从性并改善临床效果。随着临床护理的发展，将基于文化的策略与优化的药物治疗相结合至关重要。未来的努力应集中在尊重文化价值观并支持长期管理以减少糖尿病差异的综合护理模式上。
