title: Barriers to achieving optimal glycemic control in a multi-ethnic society: a US focus.
abstract: The increasing prevalence of diabetes is particularly apparent in certain ethnic groups, such as African and Hispanic Americans. These groups generally also have poorer glycemic control and outcomes. To better understand the issues surrounding these problems and possible methods to overcome them we performed a literature review from the past 15 years on barriers to glycemic control with a focus on US data. The literature reveals that barriers may be inherent (eg, genetic, cultural, and language/communication) or acquired (eg, those associated with changes in lifestyle and socioeconomic factors). Healthcare interventions that take into consideration cultural and population-specific characteristics can reduce the prevalence and severity of diabetes and its resulting complications. Implementing such strategies will require suitable education for patients and providers, the availability of culturally-sensitive, patient-centered healthcare teams, the creation of collaborative relationships between providers and patients, better use of community resources, and assistance for patients to make informed decisions about available treatment options. There is also evidence suggesting that at the same level of glucose control Hispanics and African Americans have the same degree of complications as whites; therefore, good control is essential for the future well-being of all patients. Addressing these issues may help to decrease the ethnic disparities that currently exist in diabetes care.
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, University of Tennessee College of Medicine, Memphis, Tennessee 38163, USA. sdagogojack@utmem.edu
authors.forename: Samuel
authors.initials: S
authors.lastname: Dagogo-Jack
authors.forename: Martha M
authors.initials: MM
authors.lastname: Funnell
authors.forename: Jaime
authors.initials: J
authors.lastname: Davidson
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D003142:Communication; D018864:Cultural Diversity; D003469:Culture; D003920:Diabetes Mellitus / Q000517:prevention & control*; D006801:Humans; D007802:Language; D008019:Life Style; D008913:Minority Groups; D010353:Patient Education as Topic; D014481:United States
chemical_list: D001786:Blood Glucose