Diabetes in People from Ethnic Minority Groups

The prevalence of diabetes is generally greater in people of African and Asian origin and this is particularly true of Type 2 syndrome. Also, the diabetes tends to occur at a younger age, and in general there is a quicker progression to a requirement for insulin treatment. There are a number of potential difficulties that can affect the treatment and management of diabetes in people from ethnic minorities. These include diet (some traditional foods are high in fat, sugar and salt), religious customs and cultural beliefs, health beliefs and attitudes, language, and family and social constraints.

Among the older generation, understanding of the English language may be limited and this can present difficulties in education about diabetes. It is still the case that most of the information leaflets and educational materials are written in English, with a cultural bias towards the majority population, although the position is now changing, especially in areas where there are large numbers of people from ethnic minorities. Ideally, a diabetes clinic should be able to call upon the services of an independent interpreter in the language required.

However, in practice, the interpreter is usually a younger member of the patient's family. This in itself can cause problems with regard to confidentiality, and information may not always be accurately passed on. It is recognized that a person from an ethnic minority may be subject to greater religious, cultural and family constraints and less free to act independently.

Hence any suggested dietary and lifestyle changes have to reflect and fit in with this - for example, it is important that the person who prepares the family meals understands the needs of the person with diabetes. Treatment regimes and advice may need to allow for religious customs such as fasting, and compromise may often be needed to allow for religious observance while at the same time safeguarding the person's health.

Gestational diabetes has a higher incidence among women from certain racial groups and nephropathy, coronary heart disease and circulatory disease are common complications among people of both sexes. People of Indian origin may have a lower incidence of retinopathy and diabetic foot disease. Among diabetes healthcare professionals, there is now a greater understanding of the potential difficulties that can occur and a willingness to address these when they arise.

• Diabetes and pregnancy
• Gestational diabetes
• Diabetes in children
• Diabetes in elders