title: The global challenge of type 2 diabetes and the strategies for response in ethnic minority groups.
abstract: Ethnic minorities living in high-income countries usually exhibit a greater risk of developing diabetes along with higher morbidity and mortality rates. We evaluated the effectiveness of interventions to improve glycaemic control in ethnic minority groups. Results of major controlled trials, systematic reviews and meta-analyses were included in the review. Only 1/47 studies addressing diet and exercise interventions reported details on the ethnicity of the studied population. Self-management education was successful if associated with increased self-efficacy; delivered over a longer period; of high intensity; culturally tailored; and when using community educators. Strategies adopted in community-gathering places, family-based, multifaceted, and those tackling the social context were likely to be more effective. A positive relationship was found between social support and self-management behaviour as well as quality of life, but there is little evidence about the impact of organizational changes within health-care services on diabetes control. More research is needed to strengthen the evidence on effective strategies for response to diabetes in ethnic minorities. Also, there is a need to take into account diabetes beliefs and communication difficulties, as well as potential protective factors. Globally, many health-care systems are inadequately equipped to improve diabetes prevention and disease outcomes in these communities.
authors.affiliation: Department of Medical and Surgical Sciences, University of Padua Medical School, Italy. flavio.lirussi@unipd.it
authors.forename: Flavio
authors.initials: F
authors.lastname: Lirussi
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D001786:Blood Glucose / Q000378:metabolism; D019090:Case Management; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000451:nursing / Q000628:therapy*; D003927:Diet, Diabetic; D006266:Health Education; D006301:Health Services Needs and Demand; D006801:Humans; D008875:Middle Aged; D008913:Minority Groups; D009043:Motor Activity; D010353:Patient Education as Topic; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012648:Self Care
chemical_list: D001786:Blood Glucose