Personalized Lifestyle Modifications for Improved Metabolic Health: The Role of Cultural Sensitivity and Health Communication in Type 2 Diabetes Management.

IF 6.8 4区 医学 Q1 NUTRITION & DIETETICS Journal of the American Nutrition Association Pub Date : 2024-10-14 DOI:10.1080/27697061.2024.2413368
Catherine Saenz, Manisha Salinas, Russell L Rothman, Richard O White
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Abstract

Type 2 Diabetes (T2D) is a chronic multifaceted metabolic condition characterized by elevated blood glucose levels with varying degrees of insulin resistance and abnormal insulin production. Lifestyle modifications, such as those defined by the guidelines for diabetes self-management education and support (DSMES), are foundational for glycemic control. A current gap in T2D management is addressing DSMES which is tailored to best serve the diversity of patients with this disease. The purpose of this narrative review is to discuss the current literature related to lifestyle modification for T2D, the importance of culturally sensitive T2D management programs, and the impact culturally sensitive and diverse T2D management programs have on cardiometabolic health. Despite being disproportionately affected by T2D, racial and ethnic minorities have low referral rates for DSMES. This growing disparity may be exacerbated by a lack of awareness of how to adapt lifestyle modifications in a culturally competent manner and how social determinants of health (SDOH) may affect the infrastructure and resources available to diverse patient populations. Currently, there is limited research on how DSMES is addressed to include culturally and literacy-sensitive recommendations in the United States. Patient-centered care, emphasizing personalized DSMES, can lead to improved glycemic control, reduced healthcare costs, and improved cardiometabolic health. A key component of effective DSMES should include culturally and literacy-sensitive approaches with an awareness of the impact of SDOH. Understanding how ethnicity, race, and culture influence experiences with T2D management can help providers prescribe more patient-centered and sustainable recommendations.

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改善代谢健康的个性化生活方式调整:文化敏感性和健康沟通在 2 型糖尿病管理中的作用。
2 型糖尿病(T2D)是一种多方面的慢性代谢疾病,其特点是血糖水平升高,伴有不同程度的胰岛素抵抗和胰岛素分泌异常。生活方式的调整,如糖尿病自我管理教育和支持(DSMES)指南所定义的生活方式,是控制血糖的基础。目前,在 T2D 管理方面存在的一个不足是,糖尿病自我管理教育和支持(DSMES)需要量身定制,以便为不同的糖尿病患者提供最佳服务。这篇叙述性综述的目的是讨论与改变 T2D 生活方式相关的现有文献、对文化敏感的 T2D 管理计划的重要性,以及对文化敏感且多样化的 T2D 管理计划对心脏代谢健康的影响。尽管少数民族受 T2D 的影响尤为严重,但他们的 DSMES 转诊率却很低。由于不了解如何以符合文化习惯的方式调整生活方式,也不了解健康的社会决定因素(SDOH)会如何影响为不同患者群体提供的基础设施和资源,这种日益扩大的差异可能会进一步加剧。目前,在美国,有关如何解决 DSMES 问题以纳入文化和扫盲敏感性建议的研究十分有限。以患者为中心的护理强调个性化的 DSMES,可改善血糖控制、降低医疗成本并改善心脏代谢健康。有效 DSMES 的一个关键组成部分应包括对文化和识字敏感的方法,并意识到 SDOH 的影响。了解民族、种族和文化对 T2D 管理经验的影响,有助于医疗服务提供者提出更以患者为中心、更可持续的建议。
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