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

02 May 2021
Volume 3 · Issue 5


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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