title: Disparities in diabetes mellitus among Caribbean populations: a scoping review.
abstract: BACKGROUND
  Despite the large body of research on racial/ethnic disparities in health, there are limited data on health disparities in Caribbean origin populations. This review aims to analyze and synthesize published literature on the disparities in diabetes mellitus (DM) and its complications among Afro-Caribbean populations.
  
  
  METHODS
  A detailed protocol, including a comprehensive search strategy, was developed and used to identify potentially relevant studies. Identified studies were then screened for eligibility using pre-specified inclusion and exclusion criteria. An extraction form was developed to chart data and collate study characteristics including methods and main findings. Charted information was tagged by disparity indicators and thematic analysis performed. Disparity indicators evaluated include ethnicity, sex, age, socioeconomic status, disability and geographic location. Gaps in the literature were identified and extrapolated into a gap map.
  
  
  RESULTS
  A total of 1009 diabetes related articles/manuscripts, published between 1972 and 2013, were identified and screened. Forty-three studies met inclusion criteria for detailed analysis. Most studies were conducted in the United Kingdom, Trinidad and Tobago and Jamaica, and used a cross-sectional study design. Overall, studies reported a higher prevalence of DM among Caribbean Blacks compared to West African Blacks and Caucasians but lower when compared to South Asian origin groups. Morbidity from diabetes-related complications was highest in persons with low socioeconomic status. Gap analysis showed limited research data reporting diabetes incidence by sex and socioeconomic status. No published literature was found on disability status or sexual orientation as it relates to diabetes burden or complications. Prevalence and morbidity were the most frequently reported outcomes.
  
  
  CONCLUSIONS
  Literature on diabetes health disparities in Caribbean origin populations is limited. Future research should address these knowledge gaps and develop approaches to reduce them.
authors.affiliation: Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston, West Indies, Jamaica. nadia.bennett@uwimona.edu.jm.
authors.forename: Nadia R
authors.initials: NR
authors.lastname: Bennett
authors.affiliation: Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston, West Indies, Jamaica. damian.francis@uwimona.edu.jm.
authors.forename: Damian K
authors.initials: DK
authors.lastname: Francis
authors.affiliation: Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston, West Indies, Jamaica. trevor.ferguson02@uwimona.edu.jm.
authors.forename: Trevor S
authors.initials: TS
authors.lastname: Ferguson
authors.affiliation: Chronic Disease Research Centre, Tropical Medicine Research Institute, The University of the West Indies, Bridgetown, West Indies, Barbados. ahennis1@gmail.com.
authors.forename: Anselm J M
authors.initials: AJ
authors.lastname: Hennis
authors.affiliation: Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston, West Indies, Jamaica. rainford.wilks@uwimona.edu.jm.
authors.forename: Rainford J
authors.initials: RJ
authors.lastname: Wilks
authors.affiliation: The University of the West Indies, Kingston, West Indies, Jamaica. enigel.harris@uwimona.edu.jm.
authors.forename: Eon Nigel
authors.initials: EN
authors.lastname: Harris
authors.affiliation: Department of Medical Education, Morehouse School of Medicine, Atlanta, USA. mmacleish@msm.edu.
authors.forename: Marlene M Y
authors.initials: MM
authors.lastname: MacLeish
authors.affiliation: The Sullivan Alliance, Alexandria, USA. sullivan@pemsm.com.
authors.forename: Louis W
authors.initials: LW
authors.lastname: Sullivan
mesh_terms: D000328:Adult; D017691:Caribbean Region / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000208:ethnology* / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000628:therapy; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult