Innovative Approaches to Understanding and Addressing Health Disparities in Diabetes Care and Research

With the recent published update on the management of hyperglycemia in patients with type 2 diabetes (T2D) as outlined from the American Diabetes Association and the European Association for the Study of Diabetes 2012 position statement, treatment strategies continue to evolve (1). The update is very timely when one considers the growing number of new agents and, as stated by the authors, the “growing uncertainty regarding their proper selection and sequence” (1). The approach to the patient from the position statement clarified the separation of those factors felt to be “modifiable” (i.e., patient attitude, resources, support system, etc.) as opposed to those that usually are not (i.e., disease duration, life expectancy, comorbidities, etc.). However, as timely and up-to-date as the recommendations seem to be, and that the focus continues to be on personalizing treatment strategies, there are other important factors not considered or addressed by the update that greatly affect our treatment decisions.Specifically, we recognize that among the world’s population there are observable differences in diabetes prevalence, incidence, mortality, and disease burden that clearly impact our approach to treatment (2). While these factors contribute to disparities in diabetes presentation, diagnosis, and treatment, they are not easily measured, adequately studied, or routinely considered in daily management. Given the importance of the topic of health disparities in diabetes, our editorial team has featured six articles in this issue of Diabetes Care that report on research related to understanding health disparities. The topics range from discussing the impact of interventions led by community health workers (CHWs) to understanding the role of language barriers on diabetes complications, evaluating cerebral structural changes in diabetic kidney disease in African Americans (AAs), and understanding racial differences in underlying biological factors (3–8).It is reported that minority groups in the U.S. may have less …