Exploring diabetes management with West-African immigrants living in the UK: a constructivist grounded theory study.

Background: Diabetes has become a global burden with Type 2 diabetes accounting for most of the burden of diabetes. Immigrant populations, especially African immigrants, are faced with a double burden of the condition, due to the high prevalence of Type 2 diabetes and the poorer management outcomes among this population. Although studies have explored Type 2 diabetes management among ethnic minority groups, there is a lack of research in the area of West African immigrants living with Type 2 diabetes. As a result, there is a need to explore the management process and experiences of these individuals living in Western countries. This study aims to contribute to addressing the gap in the literature by highlighting issues that are specific to this group. Methods: A qualitative approach was used to explore the experiences of thirty-four West African individuals living with diabetes in boroughs of the London area. A constructivist grounded theory approach was adopted to construct the meaning of managing Type 2 diabetes to these individuals. Participants were recruited through Type 2 diabetes support groups and within the community using purposive and snowball sampling techniques. Findings: A substantive theory of normality: adapting to the new in managing Type 2 diabetes among West African immigrants emerged. Three major categories striving to adapt’, ‘finding out’ and ‘living with it’ from experiences of living with Type 2 diabetes were developed. These major categories influence their framing of normality in the process of Type 2 diabetes management in the UK. Cultural beliefs and practices stand out as important aspects of managing Type 2 diabetes among this population in the UK. It is important that previous experiences of living in West Africa should not be separated from their current management of Type 2 diabetes in the UK. Conclusion: The findings highlight the importance of centring the management of Type 2 diabetes on the cultural influences on lifestyle choices of these individuals as evidenced by their adapted strategies to living with diabetes in the UK. Understanding normality for these individuals and how to support them in improving their Type 2 diabetes management is an important aspect for healthcare professionals to incorporate in management regime recommendations

Mental health among ethnic groups with diabetes in the UK

Mental health among ethnic minority groups living with diabetes in the UK is an area that requires urgent attention from the research communities in UK. Globally diabetes affects more than 422 million people while in the UK more than 4 million people are affected by diabetes. Ethnic minority groups in the UK are at least six times more at risk of developing diabetes than the general population. In similar trend, mental health has been reported to be more prevalent among ethnic minority in the UK. Already ethnic minority groups experience poorer health outcomes from diabetes leading to complications like mental health. This is because diabetes and mental health have two-way relationship. The purpose of this presentation is to highlight the need for ethnic minority specific research into the extent of mental health issues among the growing number of ethnic minority groups living with diabetes in the UK. This therefore requires that research communities focus more on the issue of mental health among ethnic minority groups living with diabetes in the UK. Review of factsheets surrounding Mental health and diabetes among ethnic minority groups has been brought together to point out this area that has witnessed limited research among healthcare researchers. The economic and clinical burden of the issue of mental health has been highlighted to reiterate the need for research and clinical efforts to prevent mental health complications among ethnic minority groups living with diabetes in the UK

Diabetes prevention and management in South Asia: A call for action

Background: Globally, the number of people living with Diabetes Mellitus (DM) has increased by four-folds since 1980. South Asia houses one-fifth of the world’s population living with diabetes and it was the 8th leading cause of deaths in 2013 for South Asians. Aim: To review and discuss the context of diabetes in South Asia with a particular focus on a) contributing factors and impact; b) national health policies around non-communicable diseases in the region and; c) to offer recommendations for prevention and management of diabetes. Method: We assessed relevant publications using PubMed, Scopus and OvidSP. Similarly, the World health Organization (WHO) and relevant ministries of each South Asian country were searched for reports and policy documents. Results: Emerging evidence supports that the prevalence of diabetes (ranges from 3.3% in Nepal up to 8.7% in India) in South Asia follows the global trend over the past decades. Urban populations in the region demonstrate a higher prevalence of diabetes although is also a public health concern for rural areas. Changes in the pattern and types of diet along with increasingly sedentary lifestyles are major causes for diabetes. Overall agenda of health promotion to prevent diabetes has not yet been established in the region and majority of the countries in the region are inadequately prepared for the therapeutic services for diabetes. Conclusion: The early onset of the diabetes, longevity of morbidity and early mortality may have a significant impact on people's health expenditure and health system as well as on the region's demographic composition. There is an urgent need to reduce the diabetes prevalence in the region through evidence-based interventions ranging from prevention and early detection to appropriate treatment and care. We suggest that a multi-sectorial collaboration across all stakeholders is necessary to raise awareness about diabetes, its prevention, treatment and care in the region

Diabetes prevention and management in South Asia

Background: Globally, the number of people living with Diabetes Mellitus (DM) has increased four-fold since 1980. South Asia houses one-fifth of the world’s population living with diabetes, and it was the 8th leading cause of deaths in 2013 for South Asians.Aim: To review and discuss the context of diabetes in South Asia, with a particular focus on, a) contributing factors and impact; b) national health policies around non-communicable diseases in the region, and c) to o er recommendations for prevention and management of diabetes.Method: We assessed relevant publications using PubMed, Scopus and OvidSP. Similarly, the World health Organization (WHO) and relevant ministries of each South Asian country were searched for reports and policy documents.Results: Emerging evidence supports that the prevalence of diabetes (ranging from 3.3% in Nepal up to 8.7% in India) in South Asia follows the global trend over the past decades. Urban populations in the region demonstrate a higher prevalence of diabetes, although is also a public health concern for rural areas. Changes in the pattern and types of diet, together with increasingly sedentary, lifestyles are major causes of diabetes. The overall agenda of health promotion to prevent diabetes has not yet been established in the region, and the majority of the countries in the region are inadequately prepared for the therapeutic services for diabetes.Conclusions: The early onset of the diabetes, longevity of morbidity and early mortality may have a significant impact on people’s health expenditure and health systems, as well as on the region’s demographic composition. There is an urgent need to reduce the prevalence of diabetes in the region through evidence-based interventions ranging from prevention and early detection to appropriate treatment and care. We suggest that a multi-sectorial collaboration across all stakeholders is necessary to raise awareness about diabetes, its prevention, treatment and care in the region

Examining the profound effects of COVID19 on mental health:A comprehensive systematic review on anxiety and depression

The COVID-19 pandemic has presented challenges to humanity, economically and in health and wellbeing. The associated limited social isolation and lifestyle changes has increased the risk for mental health services, especially among vulnerable people. This highlights the need for mental health services, burden that already stretch the health systems. This review presents an exposition on COVID-19 and mental health, and ways to minimise, and possibly prevent, their effect on the psychological well-being of those people. We searched four databases (Academic Search Complete, CINAHL Plus, PsycINFO and PsycARTICLES) using specific search terms and eligibility criteria. Of the 33 included studies, 31 were quantitative, and one qualitative and mixed method each. The studies were analysed using thematic narrative synthesis that resulted in three main themes: (a) the internal and external influences on COVID-19 behaviour, (b) the impact of COVID-19 on health and well-being and (c) the coping strategies used. Since COVID-19 will exist for the foreseeable future, understanding its impact on health and mental well-being and the coping techniques to be adopted are important now than ever. This study contributes to such an understanding along with suggestions regarding ways to minimise the impact of COVID-19 on mental health using context-appropriate strategies

Mental health in BME groups with diabetes: an overlooked issue?

A recent commentary in The Lancet emphasised the effect of mental health on diabetes. We would particularly like to highlight the mental health issues of black and minority ethnic (BME) populations with diabetes in the UK, owing to the considerably higher prevalence of diabetes and mental illness among BME populations compared with the national average