Management of type 2 diabetes mellitus in diverse populations

Recent studies of DIRECT and DROPLET, looked at the impact of a low-calorie diet on weight and diabetes. Both studies found that individuals achieved significant weight loss through a low-calorie diet with total diet replacement using shakes, soups and snacks of <1000kcals/day (Astbury et al., 2018). Within the DROPLET trial participants lost an average of 10.7kg and had improvements in blood pressure and HbA1c. Based on this evidence, the NHS is delivering a programme which provides a low-calorie diet treatment for individuals who are overweight with T2DM.

Evidence reports that ethnic minorities suffer disproportionately from diabetes related complications, including higher rates of hospital admissions (Gumber and Gumber, 2017). Despite this evidence of inequalities in the burden of T2DM, there is limited evidence of suitable treatment and prevention for this population group.It is known that food practices are not homogenous and vary not only by ethnicity, but also by religion, background, generation, and age (Wallia et al., 2013). Behaviour change, and patient barriers are likely to play an impact on the success of the compliance in the NHS programme.

My PhD will analyse the factors which impact following dietary advice of a low-calorie diet for T2DM in ethnic minority populations. There is a need for interventions and research which engage those from an ethnic minority background to bridge inequalities and address rising levels of diagnosis and complications of this chronic disease.

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