References

Admiraal WM, Vlaar EM, Nierkens V Intensive lifestyle intervention in general practice to prevent type 2 diabetes among 18 to 60-year-old South Asians: 1-year effects on the weight status and metabolic profile of participants in a randomized controlled trial. PLoS One. 2013; 8:(7) https://doi.org/10.1371/journal.pone.0068605

Barnard-Kelly KD, Cherñavvsky D. Social Inequality and Diabetes: A Commentary. Diabetes Ther. 2020; 11:(4)803-811 https://doi.org/10.1007/s13300-020-00791-4

Barron E, Bakhai C, Kar P Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole-population study. Lancet Diabetes Endocrinol. 2020; 8:(10)813-822 https://doi.org/10.1016/S2213-8587(20)3027-2

British Medical Association. The hidden impact of COVID-19 on patient care in the NHS in England. 2020. https://www.bma.org.uk/media/2841/the-hidden-impact-of-covid_web-pdf.pdf (accessed 26 April 2021)

Carr MJ, Wright AK, Leelarathna L Impact of COVID-19 on diagnoses, monitoring and mortality in people with type 2 diabetes: a UK-wide cohort study involving 14 million people in primary care. 2020; https://doi.org/10.1101/2020.10.25.20200675

COVIDIAB Registry. The Global Registry of New-Onset Covid-19-Related Diabetes. 2020. https://covidiab.e-dendrite.com/introduction.html (accessed 26 April 2021)

Emadian A, England C, Thompson J. Dietary intake and factors influencing eating behaviours in overweight and obese South Asian men living in the UK: mixed method study. BMJ Open. 2017; 7 https://doi.org/10.1136/bmjopen-2017-016919

Feldman EL, Savelieff MG, Hayek SS, Pennathur S, Kretzler M, Pop-Busui R. COVID-19 and Diabetes: A Collision and Collusion of Two Diseases. Diabetes. 2020; 69:(12)2549-2565 https://doi.org/10.2337/dbi20-0032

Goff LM. Ethnicity and Type 2 diabetes in the UK. Diabet Med. 2019; 36:(8)927-938 https://doi.org/10.1111/dme.13895

Golden SH, Brown A, Cauley JA Health disparities in endocrine disorders: biological, clinical, and nonclinical factors--an Endocrine Society scientific statement. J Clin Endocrinol Metab. 2012; 97:(9)E1579-E1639 https://doi.org/10.1210/jc.2012-2043

Gov.uk. Actions for Schools during the Coronavirus Outbreak. 2020. https://www.gov.uk/government/publications/actions-for-schools-during-the-coronavirus-outbreak (accessed 26 April 2021)

Guidelines. Comparison table: pharmacological management of type 2 diabetes mellitus (adults) – ADA/EASD, NICE and SIGN. 2020. https://www.guidelines.co.uk/diabetes/type-2-diabetes-pharmacological-management-pathway-comparison/454630.article (accessed 26 April 2021)

Hill-Briggs F, Adler NE, Berkowitz SA Social Determinants of Health and Diabetes: A Scientific Review. Diabetes Care. 2020; 44:(1)258-279 https://doi.org/10.2337/dci20-0053

Holman N, Knighton P, Kar P Risk factors for COVID-19-related mortality in people with type 1 and type 2 diabetes in England: a population-based cohort study. The Lancet Diabetes & Endocrinology. 2020; 8:(10)823-833 https://doi.org/10.1016/s2213-8587(20)30271-0

Jayaweera H. Migrant diversity and determinants of health care access and use. J Health Serv Res Policy. 2021; 26:(1)1-2 https://doi.org/10.1177/1355819620976272

Medical Committee for Human Rights Speech. 1966. https://aepc.us/of-all-the-forms-of-inequality-injustice-in-health-care-is-the-most-shocking-and-inhumane/ (accessed 26 April 2021)

Li J, Wang X, Chen J, Zuo X, Zhang H, Deng A. COVID-19 infection may cause ketosis and ketoacidosis. Diabetes Obes Metab. 2020; 22:(10)1935-1941 https://doi.org/10.1111/dom.14057

Lindner LME, Rathmann W, Rosenbauer J. Inequalities in glycaemic control, hypoglycaemia and diabetic ketoacidosis according to socio-economic status and area-level deprivation in Type 1 diabetes mellitus: a systematic review. Diabet Med. 2018; 35:(1)12-32 https://doi.org/10.1111/dme.13519

McCarthy EM, Rinella ME. The role of diet and nutrient composition in nonalcoholic Fatty liver disease. J Acad Nutr Diet. 2012; 112:(3)401-409 https://doi.org/10.1016/j.jada.2011.10.007

McCoy R, Dykhoff H, Sangaralingham L Adoption of New Glucose-Lowering Medications in the US – The Case of SLG2 Inhibitors: Nationwide Cohort Study. Diabetes Technology & Therapeutics. 2019; 21 https://doi.org/10.1089/dia.2019.0213

McQuaid EL, Landier W. Cultural Issues in Medication Adherence: Disparities and Directions. J Gen Intern Med. 2018; 33:(2)200-206 https://doi.org/10.1007/s11606-017-4199-3

Modi N, Thomas EL, Uthaya SN, Umranikar S, Bell JD, Yajnik C. Whole body magnetic resonance imaging of healthy newborn infants demonstrates increased central adiposity in Asian Indians. Pediatr Res. 2009; 65:(5)584-587 https://doi.org/10.1203/pdr.0b013e31819d98be

Montesi L, Caletti MT, Marchesini G. Diabetes in migrants and ethnic minorities in a changing World. World J Diabetes. 2016; 7:(3)34-44 https://doi.org/10.4239/wjd.v7.i3.34

Ng S, Woodger K, Regan F Presentation of newly diagnosed type 1 diabetes in children and young people during COVID-19: a national UK survey. BMJ Paediatrics. 2020; 4 https://doi.org/10.1136/bmjpo-2020-000884

NHS England. Reducing health inequalities resources. 2019a. https://www.england.nhs.uk/about/equality/equality-hub/resources/ (accessed 26 April 2021)

NHS England. Missed GP appointments costing NHS millions2019 05.08.2019. 2019b. https://www.england.nhs.uk/2019/01/missed-gp-appointments-costing-nhs-millions/2019/ (accessed 26 April 2021)

National Institute of Health and Care Excellence. Type 2 diabetes in adults: management. 2020. https://www.nice.org.uk/guidance/ng28/resources/2019-surveillance-of-diabetes-nice-guidelines-ng17-ng18-ng19-and-ng28-6837997933/chapter/Surveillance-decision?tab=evidence (accessed 21 April 2021)

Census Data.Newport, UK: ONS; 2011

Parsons J, Bryce C, Atherton H. Which patients miss appointments with general practice and why? A systematic review. Br J Gen Pract. 2021; https://doi.org/10.3399/BJGP.2020.1017

Petrie JR, Boyle JG, Ali K, Smith C, Morrison D, Kar P. A post COVID-19 ‘Marshall Plan' for type 2 diabetes. Diabet Med. 2021; 38:(1) https://doi.org/10.1111/dme.14439

How to make the most of your consultations in diabetes care with people living with diabetes. 2020. http://www.idealdiabetes.com (accessed 26 April 2021)

Pouwer F, Schram MT, Iversen MM, Nouwen A, Holt RIG. How 25 years of psychosocial research has contributed to a better understanding of the links between depression and diabetes. Diabetic Medicine. 2020; https://doi.org/10.1111/dme.14227

Public Health England. Location action on health inequalities Understanding and reducing ethnic inequalities in health. 2018. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/730917/local_action_on_health_inequalities.pdf (accessed 26 April 2021)

Rayman G, Lumb A, Kennon B Guidelines for the management of diabetes services and patients during the COVID-19 pandemic. Diabetic Medicine. 2020; 37:(7)1087-1089 https://doi.org/10.1111/dme.14316

Razai MS, Osama T, McKechnie DGJ, Majeed A. Covid-19 vaccine hesitancy among ethnic minority groups. BMJ. 2021; 372 https://doi.org/10.1136/bmj.n513

Ren H, Yang Y, Wang F, Yan Y, Shi X, Dong K, Yu X, Zhang S. Association of the insulin resistance marker TyG index with the severity and mortality of COVID-19. Cardiovascular Diabetology. 2020; 19:(1)

Rabbone I, Schiaffini R, Cherubini V, Maffeis C, Scaramuzza A. Diabetes Study Group of the Italian Society for Pediatric Endocrinology and Diabetes. Has COVID-19 Delayed the Diagnosis and Worsened the Presentation of Type 1 Diabetes in Children?. Diabetes Care. 2020; 43:(11)2870-2872 https://doi.org/10.2337/dc20-1321

Rebolledo JA, Arellano R. Cultural Differences and Considerations When Initiating Insulin. Diabetes Spectr. 2016; 29:(3)185-190 https://doi.org/10.2337/diaspect.29.3.185

Rodriguez-Gutierrez R, Herrin J, Lipska K, Montori V, Shah N, McCoy R. Racial and Ethnic Differences in 30-Day Hospital Readmissions Among US Adults With Diabetes. JAMA Netw Open. 2019; 2:(10) https://doi.org/10.1001/jamanetworkopen.2019.13249

Rubino F, Amiel SA, Zimmet P New-Onset Diabetes in Covid-19. N Engl J Med. 2020; 383:(8)789-790 https://doi.org/10.1056/NEJMc2018688

Santorelli G, McCooe M, Sheldon TA, Wright J, Lawton T. Ethnicity, pre-existing comorbidities, and outcomes of hospitalised patients with COVID-19. Wellcome Open Research. 2021; 6 https://doi.org/10.12688/wellcomeopenres.16580.1

Saunders CL, Steventon A, Janta B Healthcare utilization among migrants to the UK: cross-sectional analysis of two national surveys. J Health Serv Res Policy. 2021; 26:(1)54-61 https://doi.org/10.1177/1355819620911392

Shersher V, Haines TP, Sturgiss L, Weller C, Williams C. Definitions and use of the teach-back method in healthcare consultations with patients: A systematic review and thematic synthesis. Patient Educ Couns. 2021; 104:(1)118-129 https://doi.org/10.1016/j.pec.2020.07.026

Singh BM, Bateman J, Viswanath A Risk of COVID-19 hospital admission and COVID-19 mortality during the first COVID-19 wave with a special emphasis on ethnic minorities: an observational study of a single, deprived, multiethnic UK health economy. BMJ Open. 2021; 11:(2) https://doi.org/10.1136/bmjopen-2020-046556

Singh S, Kuftinec GN, Sarkar S. Non-alcoholic Fatty Liver Disease in South Asians: A Review of the Literature. J Clin Transl Hepatol. 2017; 5:(1)76-81 https://doi.org/10.14218/JCTH.2016.00045

Stewart R. How do we recover from COVID-19? Helping diabetes teams foresee and prepare for the psychological harms. Diabet Med. 2020; 37:(10)1655-1657 https://doi.org/10.1111/dme.14360

Strain WD, Cos X, Hirst M Time to do more: addressing clinical inertia in the management of type 2 diabetes mellitus. Diabetes Res Clin Pract. 2014; 105:(3)302-312 https://doi.org/10.1016/j.diabres.2014.05.005

Suwanwongse K, Shabarek N. Newly diagnosed diabetes mellitus, DKA, and COVID-19: Causality or coincidence? A report of three cases. J Med Virol. 2021; 93:(2)1150-1153 https://doi.org/10.1002/jmv.26339

Thakur ML, Sharma S, Kumar A Nonalcoholic fatty liver disease is associated with subclinical atherosclerosis independent of obesity and metabolic syndrome in Asian Indians. Atherosclerosis. 2012; 223:(2)507-11 https://doi.org/10.1016/j.atherosclerosis.2012.06.005

Whyte MB, Hinton W, McGovern A Disparities in glycaemic control, monitoring, and treatment of type 2 diabetes in England: A retrospective cohort analysis. PLoS Med. 2019; 16:(10) https://doi.org/10.1371/journal.pmed.1002942

Wolf R, Nagpal M, Magge S. Diabetes and cardiometabolic risk in South Asian youth: A review. Pediatr Diabetes. 2020; 22:(1)52-66 https://doi.org/10.1111/pedi.13078

World Health Organization. About social determinants of health. 2020. https://www.who.int/social_determinants/sdh_definition/en/ (accessed 26 April 2021)

Wilkinson R, Pickett K. The Spirit Level: Why Equality is Better for Everyone. Journal of Social Policy. 2013; 42:(04)840-842 https://doi.org/10.1017/s0047279413000366

Williamson AE, Ellis DA, Wilson P, McQueenie R, McConnachie A. Understanding repeated non-attendance in health services: a pilot analysis of administrative data and full study protocol for a national retrospective cohort. BMJ Open. 2017; 7:(2) https://doi.org/10.1136/bmjopen-2016-014120

Williamson EJ, Walker AJ, Bhaskaran K Factors associated with COVID-19-related death using OpenSAFELY. Nature. 2020; 584:(7821)430-436 https://doi.org/10.1038/s41586-020-2521-4

Yajnik CS, Fall CH, Coyaji KJ Neonatal anthropometry: the thin-fat Indian baby. The Pune Maternal Nutrition Study. Int J Obes Relat Metab Disord. 2003; 27:(2)173-180 https://doi.org/10.1038/sj.ijo.802219

William Buter Yeats Quotes (1865-1939). https://www.brainyquote.com/quotes/william_butler_yeats_101244 (accessed 26 April 2021)

Zhang Y, Cui Y, Shen M Comorbid Diabetes Mellitus was Associated with Poorer Prognosis in Patients with COVID-19: A Retrospective Cohort Study. 2020; https://doi.org/10.1101/2020.03.24.20042358

Zhou F, Yu T, Du R Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet. 2020; 395:(10229)1054-1062 https://doi.org/10.1016/s0140-6736(20)30566-3

Diabetes

Diabetes care: a time to review prescribing approaches and reach out to local communities

02 May 2021

Clinical Focus

02 May 2021

Volume 3 · Issue 5

ISSN (print): 2631-8385

ISSN (online): 2631-8393

Abstract

Diabetes care has undergone a rapid change in delivery since the first lockdown from COVID-19 in March 2020. As such, services have had to reshape and transform into virtual diabetes reviews. Vulnerable communities with high diabetes incidence or risk have experienced health disparities, not least because of COVID-19, but also as a result of slower medication reviews and escalation of diabetes prescribing as required. This article critically examines the presenting inequalities in diabetes care provision in the UK. In particular focusing on the experience of minority ethnic populations, who experience inequality and health disparities, especially related to prescribing of newer medications in type 2 diabetes. Evidence from studies and reports underpins the debates presented about reconsidering diabetes care delivery and in particular listening to and working with local practices and their communities to disseminate health messages and provide person-centred educational opportunities.

This article highlights practice issues regarding health disparities and the need for outreach in effective prescribing and treatment opportunities for all people with diabetes in the UK. The National Institute for Health and Care Excellence (NICE, 2020) guideline regarding management of type 2 diabetes in adults (NG28) was updated in 2020 and includes evidence in informing first choice intensification medications, including the introduction and earlier use of glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose co-transporter-2 (SGLT2) inhibitors in treatment opportunities. The inclusion of a new drug pathway in the NICE NG28 (2020) that focuses on cardiovascular disease (CVD) prevention, chronic renal failure, age and frailty are also welcomed. However, 2020/2021 also brought many challenges for individuals with diabetes and also healthcare professionals, with the pandemic appearing in the arena in March 2020. This has caused disparities in access to diabetes care and health beliefs, as highlighted by Holman et al (2020).

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Diabetes

minority ethnic communities

health disparities

health inequalities

reframing diabetes services