Disparities in Diabetes Distress and Nutrition Management Among Black and Hispanic Adults: A Mixed Methods Exploration of Social Determinants.
Santana R Silver, Kayla C Jones, Emily M Kim and 6 others
PMID 39901603WHAT IT FOUND
Black and Hispanic adults used nutrition to manage diabetes less often than White adults, and Hispanic adults had higher diabetes-related distress than White adults.
They wanted practical diet guidance, supportive care, and help with food, time, and transportation barriers.
Key findings
01White respondents reported using nutrition to manage diabetes at 46.8%, compared with 26.1% of Black respondents and 21.2% of Hispanic respondents.
0262.1% of survey respondents scored 8 or higher on the PAID-5, and Hispanic respondents had a median PAID-5 score of 13 compared with 6 among White respondents.
0367.9% of respondents reported social or material barriers to diabetes management, and 33.1% named food or diet as a barrier.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 496 of 767 eligible patients completed the survey, and participants were recruited from people attending in-person visits during the COVID-19 state of emergency, so patients with greater access barriers may be missing. The sample was not proportional to the clinic population: Black patients were overrepresented and Hispanic patients underrepresented compared with a clinic diabetes population of 60% Black, 18% Hispanic, and 10% White. No glycemic data were collected, so the study cannot link diabetes distress, nutrition barriers, or social barriers to A1C or diabetes control. The survey was shortened for feasibility, and the only validated measure was the PAID-5; other questions were adapted or created for the study. Findings come from one safety-net academic internal medicine practice, so they may not apply to other settings.
Declared interests
The authors declare no conflict of interest; the article is labelled as supported by NIH extramural research funding.
The easy way to misread this
Do not read this as proof that diabetes self-management education, medical nutrition therapy, or peer support improved diabetes distress or nutrition behaviours. The study was cross-sectional, did not collect glycemic data, and only reported what patients said at one point in time.