How culture and community shape prediabetes management

This has been quite a challenging blog to research and write. My lived experience puts me in the group of ‘white, 55-59, woman, affluent’. This group is known to be the most likely to take action including completing NHS diabetes programmes. Therefore, I needed to look wider than my own lived experiences.

Fact 1

Racial bias is still a prevalent issue within the UK’s healthcare system. Racial bias in healthcare refers to the different treatment experienced by people based on their race or ethnicity. These biases are shown in several ways, including the type of access to healthcare services, discrepancies in the quality of care provided, and racial discrimination in healthcare decision-making.

Digital therapeutics

There is greater prediabetes and diabetes prevalence in different cultures. According to DiabetesUK Achieving Equity in Diabetes: 2025-2030 Strategy, the current increase in type 2 diabetes in the under-40s in the UK is being experienced more by people from Black and South Asian ethnic backgrounds and those in deprived areas. People in these communities are up to four times more likely to develop type 2 before 40 than others. This inequality is a consequence of wider inequities such as worse access to healthcare, poor housing, insecure work and barriers to accessing healthy food.

If you want to read more then the full strategy document can be found here.

These two facts make the experience of living with prediabetes and diabetes for people from different cultures different to my own.

To help me understand more I asked my network of their lived experience examples.

“Traditionally because Jamaica doesn’t have an NHS, people see diabetes as a sickness but now in England I think younger people are very proactive with their diabetes. Taking home remedies i.e. bitters and karelia exercise and are much better informed and less likely to jump on the insulin medication band wagon. Which is usually not supported by medical professionals. We’ve evolved even though they haven’t.”

“Being Asian and with a father who has diabetes I am continually being told that I am at risk. But, I dont understand how to get the help I probably need”.

“Within the UK Arab community growing up I know many are not willing to try to find a solution. I can’t recall anyone trying exercise and better diets before taking diabetes medication. I know this mindset isn’t just in the UK but in Arab countries. Even though me and my siblings have been born and lived in the UK, I find I am the one having to encourage my siblings to take their prediabetes seriously. I have tried to support them through researching and advising but none of them seem to be as concerned as I am. I have managed to bring my prediabetes down to normal range through exercise and diet alone, I have lost weight going from 71kg to 56kg. I feel for once I have better understanding of my health.“

These lived experiences show that culture and community play a significant role in how individuals manage their condition. Factors like cultural beliefs, social support, and access to resources within a community can greatly influence a person’s ability to adopt and maintain healthy lifestyle changes, which are crucial for prediabetes management.

Exploring more about how culture impacts prediabetes management

Diet and nutrition:
Cultural food practices and beliefs about food can affect dietary choices. For example, some cultures may have staple foods high in carbohydrates or fats, making it challenging to adopt a diabetes-friendly diet.

Social support:
Strong social networks can provide encouragement and support for lifestyle changes. However, some cultures may have norms that discourage certain behaviors, like exercising in public or openly discussing health concerns.

Health beliefs:
Cultural beliefs about health and illness can influence how individuals perceive and respond to prediabetes. Some may have fatalistic views, while others may be more open to preventive measures.

Language barriers:
Language differences can create barriers to accessing information about prediabetes and its management, leading to misunderstandings and poor adherence to treatment plans.

Adopting new cultural norms:
The process of adapting to a new culture can influence dietary habits and lifestyle choices, sometimes negatively impacting prediabetes management.

Access to resources:
Communities with readily available resources like diabetes education programmes, healthy food options, and safe exercise facilities can significantly improve prediabetes management.

Community health programmes:
Community-based programmes that are culturally tailored and address the specific needs of the population can be more effective in promoting healthy behaviors.

Social support systems:
Strong community networks and social support systems can encourage individuals to adopt healthy behaviors and provide encouragement during challenging times.

Environmental factors:
The built environment, such as access to green space, parks and safe walking paths, can influence physical activity levels, which are crucial for prediabetes management.

Health disparities:
Communities with high levels of poverty and limited access to healthcare may experience greater health disparities, including higher rates of prediabetes and poorer outcomes.

Addressing prediabetes requires a more holistic approach that considers the cultural and community context in which individuals live. By understanding and addressing the social outcomes of health, tailoring interventions to cultural preferences, and encouraging strong community support, support can improve outcomes for individuals with prediabetes.

Jo Sellwood

Author

Let me introduce myself as I start sharing my diabetes connected thoughts via a set of blogs for Tesu Health. I’m a relatively newly diagnosed Type 2 diabetic if you’d say that 5 years is newly diagnosed. To me it still feels like I am learning about diabetes, how to manage my own diabetes and how the medical and research community are moving forward to help us all. My diagnosis was only confirmed after I was unwell with a completely unrelated condition. It was a surprise as I thought I was fit and healthy. A vegan marathon runner probably isn’t the first person you’d expect to have T2. Over the last 5 years I’ve moved through different medication regimes and am currently injecting slow acting insulin once a day. For me, this works well in conjunction with my (self-funded) Continuous Glucose Monitor. As a way of better understanding diabetes and my own lived experience, I volunteer with DiabetesUK. I am fortunate to be an Expert by Experience as part of their Diabetes Research Steering Group which is planning the next research into the causes of diabetes. I am a huge advocate of enabling people living with diabetes to have the knowledge, skills and support to take action and thrive. I hope you enjoy reading my blogs. You can read more through my LinkedIn posts.