The Next Generation of Diabetes Translation: A Path to Health Equity

Haire‐Joshu, Debra; Hill-Briggs, Felicia

doi:10.1146/annurev-publhealth-040218-044158

Cited by 86 publications

(70 citation statements)

References 128 publications

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“…6 The third type concerns root cause 27,56 oriented interventions designed to change underlying structures/systems rather than compensate for them. Two types represent compensatory interventions that provide supports that enable individuals to fill gaps and access otherwise inaccessible or unavailable resources to overcome influences of negative SDoH.…”

Section: Addressing Social Determinants In Community and Neighborhoodmentioning

confidence: 99%

“…6 CHWs are trained, frontline public health workers or extended healthcare team members, who often share characteristics (community, culture, and language) with their clients (individuals or families). 6 CHWs are trained, frontline public health workers or extended healthcare team members, who often share characteristics (community, culture, and language) with their clients (individuals or families).…”

Section: Community Health Worker Programsmentioning

confidence: 99%

“…Two types represent compensatory interventions that provide supports that enable individuals to fill gaps and access otherwise inaccessible or unavailable resources to overcome influences of negative SDoH. 6 The third type concerns root cause 27,56 oriented interventions designed to change underlying structures/systems rather than compensate for them.…”

Section: Addressing Social Determinants In Community and Neighborhoodmentioning

confidence: 99%

“…Specifically, Alaska Native, American Indian, Asian American, Native Hawaiian and Pacific Islander, non-Hispanic Black, b and Hispanic adults bear a disproportionate burden of illness related to these conditions compared with non-Hispanic Whites, as do those with low socioeconomic status (SES), living in rural areas, 1,2 and identifying as LGBTQ. 6 4 Efforts to scale-up and spread efficacious interventions are underway (e.g., the National Diabetes Prevention Program), 5 but our knowledge of evidence-based strategies that specifically reduce diabetes-related disparities is limited.…”

Section: Introductionmentioning

confidence: 99%

“…A central challenge in improving population health is translating research conducted under the best case scenarios of well-resourced randomized controlled trials into real-world scenarios, which requires addressing environmental, economic, and social factors that affect individuals' engagement in and response to these interventions. 6…”

Section: Introductionmentioning

confidence: 99%

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New research directions on disparities in obesity and type 2 diabetes

Thornton

Kumanyika

Gregg

et al. 2019

Annals of the New York Academy of Sciences

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Obesity and type 2 diabetes disproportionately impact U.S. racial and ethnic minority communities and low-income populations. Improvements in implementing efficacious interventions to reduce the incidence of type 2 diabetes are underway (i.e., the National Diabetes Prevention Program), but challenges in effectively scaling-up successful interventions and reaching at-risk populations remain. In October 2017, the National Institutes of Health convened a workshop to understand how to (1) address socioeconomic and other environmental conditions that perpetuate disparities in the burden of obesity and type 2 diabetes; (2) design effective prevention and treatment strategies that are accessible, feasible, culturally relevant, and acceptable to diverse population groups; and (3) achieve sustainable health improvement approaches in communities with the greatest burden of these diseases. Common features of guiding frameworks to understand and address disparities and promote health equity were described. Promising research directions were identified in numerous areas, including study design, methodology, and core metrics; program implementation and scalability; the integration of medical care and social services; strategies to enhance patient empowerment; and understanding and addressing the impact of psychosocial stress on disease onset and progression in addition to factors that support resiliency and health.Directions on disparities in obesity and diabetes Thornton et al.

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Section: Addressing Social Determinants In Community and Neighborhoodmentioning

confidence: 99%

Section: Community Health Worker Programsmentioning

confidence: 99%

Section: Addressing Social Determinants In Community and Neighborhoodmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

New research directions on disparities in obesity and type 2 diabetes

Thornton

Kumanyika

Gregg

et al. 2019

Annals of the New York Academy of Sciences

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Diabetes Care Barriers, Use, and Health Outcomes in Younger Adults With Type 1 and Type 2 Diabetes

et al. 2023

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ImportanceTreatment challenges exist for younger adults with type 1 (T1D) and type 2 diabetes (T2D). Health care coverage, access to, and use of diabetes care are not well delineated in these high-risk populations.ObjectiveTo compare patterns of health care coverage, access to, and use of diabetes care and determine their associations with glycemia among younger adults with T1D and with T2D.Design, Setting, and ParticipantsThis cohort study analyzed data from a survey that was jointly developed by 2 large, national cohort studies: the SEARCH for Diabetes in Youth (SEARCH) study, an observational study of individuals with youth-onset T1D or T2D, and the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study, a randomized clinical trial (2004-2011) followed by an observational study (2012-2020). The interviewer-directed survey was administered during in-person study visits in both studies between 2017 and 2019. Data analyses were performed between May 2021 and October 2022.Main Outcomes and MeasuresSurvey questions addressed health care coverage, usual sources of diabetes care, and frequency of care use. Glycated hemoglobin (HbA1c) levels were assayed in a central laboratory. Patterns of health care factors and HbA1c levels were compared by diabetes type.ResultsThe analysis included 1371 participants (mean [range] age, 25 [18-36] years; 824 females [60.1%]), of whom 661 had T1D and 250 had T2D from the SEARCH study and 460 had T2D from the TODAY study. Participants had a mean (SD) diabetes duration of 11.8 (2.8) years. More participants with T1D than T2D in both the SEARCH and TODAY studies reported health care coverage (94.7%, 81.6%, and 86.7%), access to diabetes care (94.7%, 78.1%, and 73.4%), and use of diabetes care (88.1%, 80.5%, and 73.6%). Not having health care coverage was associated with significantly higher mean (SE) HbA1c levels in participants with T1D in the SEARCH study (no coverage, 10.8% [0.5%]; public, 9.4% [0.2%]; private, 8.7% [0.1%]; P &lt; .001) and participants with T2D from the TODAY study (no coverage, 9.9% [0.3%]; public, 8.7% [0.2%]; private, 8.7% [0.2%]; P = .004). Medicaid expansion vs without expansion was associated with more health care coverage (participants with T1D: 95.8% vs 90.2%; participants with T2D in SEARCH: 86.1% vs 73.9%; participants with T2D in TODAY: 93.6% vs 74.2%) and lower HbA1c levels (participants with T1D: 9.2% vs 9.7%; participants with T2D in SEARCH: 8.4% vs 9.3%; participants with T2D in TODAY: 8.7% vs 9.3%). The T1D group incurred higher median (IQR) monthly out-of-pocket expenses than the T2D group ($74.50 [$10.00-$309.00] vs $10.00 [$0-$74.50]).Conclusions and RelevanceResults of this study suggested that lack of health care coverage and of an established source of diabetes care were associated with significantly higher HbA1c levels for participants with T1D, but inconsistent results were found for participants with T2D. Increased access to diabetes care (eg, through Medicaid expansion) may be associated with improved health outcomes, but additional strategies are needed, particularly for individuals with T2D.

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Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

et al. 2022

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The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the previous consensus statements on the management of hyperglycaemia in type 2 diabetes in adults, published since 2006 and last updated in 2019. The target audience is the full spectrum of the professional healthcare team providing diabetes care in the USA and Europe. A systematic examination of publications since 2018 informed new recommendations. These include additional focus on social determinants of health, the healthcare system and physical activity behaviours including sleep. There is a greater emphasis on weight management as part of the holistic approach to diabetes management. The results of cardiovascular and kidney outcomes trials involving sodium–glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists, including assessment of subgroups, inform broader recommendations for cardiorenal protection in people with diabetes at high risk of cardiorenal disease. After a summary listing of consensus recommendations, practical tips for implementation are provided. Graphical abstract Supplementary Information The online version of this article (10.1007/s00125-022-05787-2) contains peer-reviewed but unedited supplementary material.

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The Next Generation of Diabetes Translation: A Path to Health Equity

Cited by 86 publications

References 128 publications

New research directions on disparities in obesity and type 2 diabetes

New research directions on disparities in obesity and type 2 diabetes

Diabetes Care Barriers, Use, and Health Outcomes in Younger Adults With Type 1 and Type 2 Diabetes

Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

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