Examples of Improving Type 2 Diabetes Health Outcomes in Communities of Color

Gaps in type 2 diabetes care in communities of color have not yet been corrected in clinical practice. The following chart shows several potential causes for inequities in type 2 diabetes outcomes and respective proposed solutions.

Poorly Controlled Type 2 Diabetes CausePOTENTIAL SOLUTIONS
Limited knowledge about type 2 diabetes standards of care among clinicians
  • Encourage the clinical team to stay updated on standards of care through consistent, monthly refresher newsletters of main points from the American Diabetes Association (ADA)

Limited knowledge about type 2 diabetes among primary care physicians
  • Provide access to Centers for Disease Control and Prevention (CDC) tools for health care providers
  • Host a monthly clinic or grand round on type 2 diabetes prevention
Lack of strong communication by the clinical team to patients
  • Train all team members with patient education materials
Difficulty obtaining patient data on type 2 diabetes outcomes and comorbidities
  • Work with information technology (IT) and quality improvement (QI) staff to develop a report or best practice alert for physicians to manage type 2 diabetes care for patients
Medication nonadherence
  • Understanding medication adherence is a “give and take” rather than a quest for perfection
Clinical inertia in starting insulin
  • Train staff on the progression of type 2 diabetes and appropriate insulin usage
  • Educate patients on administering insulin
Cost barriers to medication
  • In medication reconciliation, ask patients about cost concerns
  • Provide resources to patients for mitigating medication costs

Cultural sensitivities among the local population
  • Use culturally appropriate and responsive patient education materials
  • Train medical assistants and front office staff to promote lifestyle changes
  • Train community leaders on benefits of lifestyle changes by equipping them with the appropriate patient education materials
  • Train health care team on why disparities exist in relation to the systemic, political, and social determinants of health

Patient hesitancy due to lack of information or fear
  • Provide clear and consistent patient education based on accepted standards of care and evidence-based interventions
  • Train clinical staff to empathize with fear or medical mistrust due to past injustices
  • Refer patients

Type 2 Diabetes Prevention and Lifestyle Change Recommendations from Providers

The CDC estimates that 90-95% of people with diabetes have type 2. With healthy lifestyle changes, such as losing weight, eating nutrient-dense foods, and staying active, type 2 diabetes can be delayed or even prevented.

A culture of improving health outcomes for patients with type 2 diabetes is essential for all clinical practice. Promoting 150 minutes of physical activity per week, managing blood sugar, and eating well by planning meals each week that contain healthier foods in the right amounts, with the understanding that some patients live in food deserts and food swamps, will assist in reducing disparities related to type 2 diabetes.

Self-education management, responding to social determinants of health are critical, and identifying resources in the community are critical.

Addressing Type 2 Diabetes Myths

As medical mistrust continues to grow, myths about type 2 diabetes are common. Dispelling both misinformation and disinformation can be challenging. The following common myths and responses are designed to help providers address these difficult conversations in practice.

“Diabetes is not a serious disease.”

The ADA consistently messages that type 2 diabetes is a serious illness. According to the ADA, type 2 diabetes causes more deaths per year than breast cancer and AIDS combined. It also increases your risk of having a heart attack. However, taking measures to manage your type 2 diabetes can reduce your risk of comorbidities and type 2 diabetes-related complications.

“I have to completely avoid carbs if I have diabetes.”

Per the ADA, there is no evidence to suggest that people with type 2 diabetes need to avoid carbs, though some people choose eating plans that avoid them. In fact, the evidence suggests that including the right amounts of carbs, protein, and fat can help manage your blood glucose levels. Working with your health care team can help you find the right balance for you. And remember, fruits and fibrous vegetables are carbs too!

“I have to eat special foods because I have diabetes.”

Healthy meal plans for people with type 2 diabetes look very much like those of people without type 2 diabetes. A healthy eating plan includes lots of fibrous vegetables, limited added sugars, whole grains, and prioritizing whole foods over processed ones.

“I ‘caught’ diabetes from a family member. My grandmother had it.”

Type 2 diabetes is a chronic condition, not an infectious disease. While it is unclear exactly why some people develop type 2 diabetes and others don’t, it is clear that type 2 diabetes is not contagious.

Ultimately, it’s important for patients to understand the severity of type 2 diabetes and that there are options for prevention or delay of the onset of complications.

Solutions Worksheet

The following worksheet can be utilized to capture the causes and solutions for common type 2 diabetes issues.

Solutions Worksheet Document

Source:
Myths about Diabetes. Myths about Diabetes | ADA. (n.d.). https://www.diabetes.org/diabetes-risk/prediabetes/myths-about-diabetes. 

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