Systematic review: Perceptions of type 2 diabetes of people of African descent living in high‐income countries

Abstract

Aims To describe how people of African descent perceive and understand type 2 diabetes, and to examine the impact of their perceptions and beliefs on the uptake of diet, exercise, weight control and adherence to medication recommendations. Design Systematic literature review of quantitative and qualitative studies. Data sources We searched MEDLINE, CINAHL Complete, Psych INFO, Academic Search Premier, Education Research Complete, Web of Science and Scopus, World Health Organization (WHO), Diabetes UK and American Diabetes Association for articles published from January 1999 to December 2019. Review methods Informed by the PRISMA guidelines, we independently reviewed titles and abstracts, identified articles for full‐text review that met inclusion criteria, conducted a quality assessment and extracted data. Findings were synthesized using a thematic approach. Results Twenty‐six studies met the inclusion criteria. Knowledge and understanding of diabetes were poor. Beliefs and behaviours about diet, exercise, weight and health care were erroneous. Most diabetic participants could not recognize diabetes symptoms, failed to take their diagnosis seriously and did not adhere to medication recommendations. The resultant effect was an increased risk of complications with undesirable outcomes. Conclusion Poor diabetes perceptions are linked to negative consequences and may be responsible for poorer outcomes among people of African descent. This review highlights the need to consider this population's beliefs and practices in structuring culturally sensitive programmes for diabetes management. Impact This systematic literature review is the first to exclusively explore perceptions of people of African descent in relation to diabetes. It is important to consider people of African descents' diabetes perceptions and practices before formulating interventions for their diabetes management.

HbA1c screening for diabetes mellitus and to evaluate diabetic control in people of African ancestry with HIV in South London

“…9 As with antiretroviral therapy, knowledge and health beliefs have a major impact on black African and African Caribbean peoples' adherence to their DM treatment; limited knowledge and understanding of DM and its risk factors, mistrust of the advice and treatments offered and a preference for natural treatments, fear of insulin, and a perception that diet-or tablet-controlled DM was a mild form that did not warrant serious concern have been reported in qualitative studies. 10,11 We recently conducted focus groups discussions on long-term conditions with people of African ancestry with HIV in South London. These confirmed previously identified obstacles and additional challenges to the successful management of comorbidities such as T2DM including poor communication with and limited trust in non-HIV healthcare providers; self-stigma and concern about inadvertent disclosure of HIV status; difficulty in navigating the health care system; lack of peer support; financial and cultural barriers to implementing lifestyle interventions; and limited knowledge of and access to culturally-sensitive information about DM and its long complications.…”

“…As with antiretroviral therapy, knowledge and health beliefs have a major impact on black African and African Caribbean peoples’ adherence to their DM treatment; limited knowledge and understanding of DM and its risk factors, mistrust of the advice and treatments offered and a preference for natural treatments, fear of insulin, and a perception that diet- or tablet-controlled DM was a mild form that did not warrant serious concern have been reported in qualitative studies. 10 , 11 …”