DRIVE for Type 2 Diabetes in Communities of Color
Type 2 diabetes outcomes in communities of color are plagued with persistent disparities. Patients in communities of color often face barriers to evidence-based treatment and support.
What is type 2 diabetes?
Type 2 diabetes is the most common form of diabetes, a chronic condition resulting in high blood glucose, as a result of progressive loss of adequate insulin secretion frequently on the background of insulin resistance. Usually arising in middle- and older-aged adults, high blood sugar can cause other serious health problems, such as heart disease, vision loss, and kidney disease.
How is type 2 diabetes treated?
The American Diabetes Association (ADA)’s Standards of Medical Care in Diabetes (Standards of Care), updated annually, provides an up-to-date evidence-based guide to comprehensive diabetes care.
- The Standards of Care opens by calling diabetes a “complex, chronic illness requiring continuous medical care with multiple risk-reduction strategies beyond glycemic control. Ongoing self-management education and support are critical to preventing acute complications and reducing the risk of long-term complications”
- The cornerstone to evidence-based type 2 diabetes management consists of: self-management education; nutrition and physical activity management; pharmacotherapy; management of comorbid disease; and depression screening
- Pharmacotherapy recommendations should be in consultation with the patient
- As a progressive disease and because of common cardiovascular and renal comorbidities, combination therapy and the use of newer agents in at-risk patients are recommended. In addition, many patients will ultimately require and benefit from insulin, in conjunction with continuous glucose monitoring (CGM)
- Patient education is fundamental, along with supports for improved diet and exercise that is culturally-sensitive and patient-centered
- Persons from racial and ethnic minority populations, those in low-income groups, and other socially marginalized groups are disproportionately affected by type 2 diabetes and experience higher disease prevalence, poorer glycemic control, higher rates of diabetes complications, and higher prevalence of comorbid conditions. Achieving glucose targets that will reduce the risk of diabetes complications, particularly among high-risk groups, is critical to improve the health and well-being of those with diabetes and to reduce health care utilization and expenditures. Yet, diabetes control remains elusive (Peek & Thomas, 2021)
Health care teams and community leaders are key to helping their patients and community members become educated about type 2 diabetes, provide tools for self-management of the disease, empower patients to become their own type 2 diabetes advocates, and disseminate resources that will promote access and support lifestyle changes.
Currently, the DRIVE Toolkit is focused on flu vaccination, COVID-19, and type 2 diabetes
Future DRIVE programs will focus on the following clinical areas:
- Cancer Screenings
- Cardiovascular Disease
Source: Peek, ME and Thomas C. Broadening Access to Continuous Glucose Monitoring for Patients With Type 2 Diabetes. JAMA:2021;325(22):2255-2257. https://doi.org/10.1001/jama.2021.6208.