Literature review of type 2 diabetes mellitus among minority Muslim populations in Israel

Abstract

This review surveys the literature published on the characteristics and implications of pre-diabetes and type 2 diabetes mellitus (T2DM) for the Arab and Bedouin populations of Israel. T2DM is a global health problem. The rapid rise in its prevalence in the Arab and Bedouin populations in Israel is responsible for their lower life expectancy compared to Israeli Jews. The increased prevalence of T2DM corresponds to increased rates of obesity in these populations. A major risk group is adult Arab women aged 55-64 years. In this group obesity reaches 70%. There are several genetic and nutritional explanations for this increase. We found high hospitalization rates for micro and macrovascular complications among diabetic patients of Arab and Bedouin origin. Despite the high prevalence of diabetes and its negative health implications, there is evidence that care and counseling relating to nutrition, physical activity and self-examination of the feet are unsatisfactory. Economic difficulties are frequently cited as the reason for inadequate medical care. Other proposed reasons include faith in traditional therapy and misconceptions about drugs and their side effects. In Israel, the quality indicators program is based on one of the world's leading information systems and deals with the management of chronic diseases such as diabetes. The program's baseline data pointed to health inequality between minority populations and the general population in several areas, including monitoring and control of diabetes. Based on these data, a pilot intervention program was planned, aimed at minority populations. This program led to a decrease in inequality and served as the basis for a broader, more comprehensive intervention that has entered the implementation stage. Interventions that were shown to be effective in other Arabic countries may serve as models for diabetes management in the Arab and Bedouin populations in Israel.

Quality of life of type 2 diabetes mellitus patients in Ramallah and al-Bireh Governorate–Palestine: a part of the Palestinian diabetes complications and control study (PDCCS)

“…A review including patients with diabetes of Arab and Bedouin origin in ‘Israel’, yet, also found evidence of high rates of hospitalizations and micro and macrovascular complications. Beyond this, the review stated that financially difficulties are frequently expressed as cause for inadequate healthcare and consequent complications [ 39 ]. Another study stated that high numbers of patients, insufficient staff training, and inadequate infrastructure are the main impediments to the proper management of diabetes in Palestine.…”

A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study

“…This study took a strengths-based approach, using the experience and analysis of community members with diabetes as the starting point both for evaluating healthcare system successes and shortcomings, and for identifying community needs, strengths and solutions. It adds to the body of strengths-based approaches in the literature that serve to counterbalance and critique deficit-based approaches characterizing Indigenous and other marginalized minority patients as "problematic" or "non-compliant" [4,6,39].…”

“…Indigenous and other marginalized racial/ethnic minorities have poorer health status than majority populations, including higher rates of type 2 diabetes, and diabetes-related complications and mortality [1][2][3]. In addressing these disparities, healthcare and government policy makers have typically used a deficit-based discourse that frames the problem as a deficiency, lack or failure of the Indigenous/minority population in comparison to a utopian non-Indigenous/majority ideal [4][5][6].…”

“…Arabs exhibit higher age-and sex-adjusted prevalence (18.4%) and annual incidence (2.9%) rates of adult-onset diabetes than the majority Jewish population (10.3% and 1.7%, respectively) [2]. They also exhibit younger age at diabetes presentation, suboptimal glycemic control, and higher diabetic complication and cause-specific mortality rates [3,6,26,27]. These diabetes disparities exist despite the presence of national health insurance, community-based primary healthcare clinics, and regional secondary and tertiary healthcare facilities.…”

Exploration of Risk Factors for Type 2 Diabetes among Arabs in Israel

“…This community is characterized by a high rate of consanguineous marriages with a common founder effect [1617]. Recently, a westernized lifestyle was adopted by most of the Arab population in Israel [18]. It was found that the main causes of death that might contribute to the lower age of Arabs compared to Jews could be due to chronic diseases, especially ischemic heart disease and diabetes [19].…”