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Type 2 Diabetes UK

African, Caribbean & South Asian


Women, Children and Youth
Diabetes Mellitus
Chronic and progressive

Raised glucose levels

Two types - 1 and 2

Type 1 - pancreas cannot produce insulin


Type 2 Diabetes

Affects mainly 40+ but changing


Symptoms appear gradually
Need to adjust diet and lifestyle
Treatment - tablets or insulin injections
Largely preventable, manageable
T2D Dangers
Damages Linked to
blood vessels/tissues obesity
eyes CVD
kidneys hypertension
nerves hyperglycaemia
UK Prevalence
3.8 million diagnosed
Older people are at high risk
Men are at higher risk
African, Caribbean & Asian higher risk
Costs 8.8bn per year
Southall and Brent (SABRE) study
50% African, African Caribbean & South Asian T2D by 80

1 in 5 European descent

South Asian men diagnosed with diabetes 5 years younger

African Caribbean and South Asian women have higher body


fat levels and insulin resistance
Diabetes Prevalence by Ethnic
Group in England (Health Survey for England 2004)
T2D & Health Inequalities
Overweight and obese

Sedentary

Particular cultural groups

Socioeconomically disadvantaged
T2D Risk Factors for BME in UK
Biological (age & sex)
SES
Lifestyle/behaviour, incl. (over)weight
Comorbidities
Lack of knowledge/screening
Barriers
Early childhood malnutrition changes the way
the body functions.
Changes in glucose insulin metabolism
reduce insulin secretion and increase insulin
resistance and in combination with age and
other lifestyle factors can increase the risk of
type 2 diabetes among ethnic minority groups.
Intervention Rationale & Aim
Culturally appropriate

Awareness + Action

Reduce BME T2D incidence in UK

Provide support
Background

1. Increased understanding of disease through


research.
2. T2D is preventable and its onset delayed.
3. People with T2D can have a good life
4. New treatments methods are there.
5. Self-care improves outcomes.
Risk Factors for diabetes in Ethnic
Minorities UK

Unhealthy dietary regime


Tobacco use
Alcohol
Lack of physical activity
Poor physiological adaptation due to climatic
variation
Model of Health Promotion

Behavior changes desired


Healthy eating
Active Lifestyle
Giving up smoking
Giving up drinking
Health Promotion Intervention

Communication
Individual Level Motivational Interviewing
Community Level Culture based campaigns
Mass Level Social Media and Mass Media
Theories to be used

Health Belief Model

Theory of Planned Behaviour

Trans-theoretical Model
Motivational Interviewing
Health Belief Model
Theory of Planned Behaviour
References - 1
Ojo, O. (2013) Diabetes in Ethnic Minorities in UK: The Role of Diet in Glucose Dysregulation and
Prevalence of Diabetes, Journal of Food and Nutritional Disorders, 2(2). Available at:
http://www.scitechnol.com/diabetes-in-ethnic-minorities-in-uk-the-role-of-diet-in-glucose-dysregulation-a
nd-prevalence-of-diabetes-xjJq.pdf
(Accessed: 3 December 2016).
Liu JJ, Davidson E, Bhopal RS, et al. (2012) Adapting Health Promotion Interventions to Meet the Needs of
Ethnic Minority Groups: Mixed-Methods Evidence Synthesis, NIHR Journals Library.
Tripp-Reimer, T., Choi, E., Kelley, L.S. and Enslein, J.C. (2001) Cultural Barriers to Care: Inverting the
Problem, Diabetes Spectrum, Jan 2001, 14 (1), pp. 13-22. Available at:
http://spectrum.diabetesjournals.org/content/diaspect/14/1/13.full.pdf (Accessed: 3 December 2016).
Netto, G., Bhopal, R., Lederle, N., Khatoon, J. and Angela, J. (2010) How can health promotion
interventions be adapted for minority ethnic communities? Five principles for guiding the development of
behavioural interventions. Health Promotion International, 25(2), pp. 248-257.
Corcoran, N. (2007) Communicating Health: Strategies for Health Promotion.\Thousand Oaks, CA: Sage.
WHO (2016) Diabetes- Fact sheet. Available at: http://www.who.int/mediacentre/factsheets/fs312/en/
(Accessed: 3 December 2016).
Diabetes UK (2016) Diabetes: The Basics. Available at: https://www.diabetes.org.uk/Diabetes-the-basics/
(Accessed: 3 December 2016).
References - 2
DH (Department of Health) (2016) Diabetes. National Service Framework for Diabetes Standards. Available
at:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/198836/National_Servic
e_Framework_for_Diabetes.pdf
(Accessed: 3 December 2016).
PHE (2016) 3.8 million people in England now have Diabetes, Gov.uk Press Release, 15 September 2016.
Available at: https://www.gov.uk/government/news/38-million-people-in-england-now-have-diabetes
(Accessed: 3 December 2016).
Wong, S. (2012) Study reveals extent of type 2 diabetes problem in minority ethnic populations. Available
at:
http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_11-9-2012-11-45-
11
(Accessed: 3 December 2016).
Rull, G. (2015) Diseases and different ethnic groups, Patient Plus, 3 December 2015. Available at:
http://patient.info/doctor/diseases-and-different-ethnic-groups (Accessed: 3 December 2016).
Sobell and Sobell (2008). Motivational interviewing strategies and techniques: rationales and examples.
Available at: http://www.nova.edu/gsc/forms/mi_rationale_techniques.pdf (Accessed: 3 December 2016).
Jalilian et al. (2014) Effectiveness of self-management promotion educational program among diabetic
patients based on health belief model, J Educ Health Promot., 3 (14). Available at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3977410/ (Accessed: 3 December 2016).
References - 3
Health Promotion International (2008) Shaping the future of health promotion - Why theory matters for
effective promotion: A briefing. Available at: http://heapro.oxfordjournals.org/content/23/1/98 (Accessed:
3 December 2016).
Misra, A., Ramchandran, A., Jayawardena, R., Shrivastava, U. & Snehalatha, C. (2014) Diabetes in South
Asians, Diabetic Medicine, October, 31(10), pp. 1153-1162.
Robbins, J. M.,Vaccarino, V., Zhang, H. &Kasl,S. V. (2001) Socioeconomic status and type 2 diabetes in
African American and non-Hispanic white women and men: evidence from the Third National Health and
Nutrition Examination Survey, American Journal of Public Health, January, 91(1), pp. 76-83.
Chaturvedi, N. (2002) Differing Aspects of Insulin Resistance in Diabetes Complications: The Shape of
things to Come. R. D. Lawrence Lecture 2000, Diabetic Medicine, December, 19(12), pp. 973-977.
NHS Diabetes (2011b) The Six Department of Health Equality Strands. Available at:
http://www.diabetes.nhs.uk/our_work_areas/inequalities/the_six_department_of_health_equality_strand
s/
(Accessed: 3 December 2016).
Sohal, T.,Sohal, P., King-Shier, K., M.& Khan, N. A. (2015) Barriers and facilitators for type-2 diabetes
management in South Asians: A systematic review. PLoS ONE, 18 September, 10(9), pp. 1-15.
Thomas, C., Nightingale, C. M.,Donin, A. S.,Rudnicka, A. R., Owen, C. G.,Sattar, N., Cook, D. G.&Whincup, P.
H. (2012) Socio-economic position and Type 2 diabetes risk factors: Patterns in UK Children of South Asian,
Black African-Caribbean and white European origin. PLoS ONE, March, 7(3), pp. 1-11.