Living with Type 2 diabetes as a BAME patient

Read on to find out how people with Type 2 diabetes in BAME communities can manage the condition.

December, 2020

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People from Black, Asian, and minority ethnic (BAME) communities are more likely to develop Type 2 diabetes than white people. What’s more, people from BAME groups tend to be diagnosed when they are younger, putting them at greater risk of long-term complications [i].

But it is important to remember that uncontrolled blood glucose levels cause complications – not the diabetes itself. There are lots of things people can do to manage their condition and live well with diabetes.

Why are people from BAME communities more at risk?

More than 500,000 of the 3.3 million people (15%) [ii] living with Type 2 diabetes in England and Wales in 2018 were from BAME groups. Studies have shown that South Asian people are up to two to four times more likely [iii] to develop the condition than white Europeans. Whereas Black people [iv] are up to three times more likely to develop the condition.

Scientists are not sure why people from BAME groups are affected more than white people. In truth, there is no one simple answer [v] as there are different factors to consider.

The condition happens when the pancreas starts having problems producing insulin [vi], the hormone that regulates levels of sugar, or glucose, in the blood.

When we eat carbohydrates, they turn into sugar and enter the bloodstream. Insulin then takes the sugar out of the blood and turns it into energy.

When the body does not have the insulin it needs, the sugar stays in the blood where it can damage the blood vessels. It is this damage that leads to long-term complications such as coronary heart disease and stroke.

Diet is a known risk factor for developing Type 2 diabetes. Some communities may eat more sugary and starchy foods than others, or use more highly saturated fats, like ghee [vii]. Insufficient regular exercise also increases the risk of Type 2 diabetes. Some groups, particularly South Asian women, tend to be less physically active [viii].

Culture and language are also important factors. We know that minority groups are less likely to have good relationships with healthcare services than the general population. And with 20% of people from BAME backgrounds having poor or no English, many find it hard to communicate with healthcare professionals. People who work with their doctors and nurses to manage their condition tend to stay healthier for longer, so communication and engagement issues are significant.

What is the diabetes community doing about it?

Scientists are working hard to understand more about diabetes and ethnicity – and to address the inequalities people from BAME communities face.

To date, Diabetes UK has invested £4.7m [ix] into more than 40 projects aimed at levelling the healthcare playing field.

In 2012, for example, the charity funded researchers at the University of Leicester to develop a Type 2 diabetes screening questionnaire for high risk, non-English speaking communities. It is also supporting a team from King’s College London to look at how the biology that contributes to the development of Type 2 differs in different ethnic groups.

Many groups are also calling for dietary advice to be more culturally relevant. Most information is geared towards the white population and does not consider that different communities eat different foods. People with diabetes need to keep a careful eye on the amount of carbohydrate they eat, but traditional BAME diets tend to be higher in foods like rice, bread, and potatoes.

When primary healthcare professionals [x] in the London Borough of Brent asked their BAME patients about it, 76.5% said the nutritional advice they had been given was not relevant to them.

In response, the team developed three food information booklets for people living with diabetes from the African and Caribbean, Gujarati, and Pakistani communities. They featured photographs of foods common in those communities, alongside breakdowns of how much carbohydrate is in each.

The idea was to give people the information they need in a way that matters to them – and it is working. Before using the booklet, just 38.2% of people could name three carbohydrate foods they ate regularly. Afterwards, that figure was 100%.

Living with diabetes as a BAME patient

People from BAME backgrounds are at a higher risk of developing Type 2 diabetes. They are also more likely to suffer long-term complications. But it does not have to be that way. There are lots of things people can do to manage their condition and stay healthier for longer.

Eating a healthy, balanced diet is the first step [xi]. Simple things like swapping white rice for brown, choosing sweet potatoes instead of regular, and opting for baked rather than fried foods, can all make a difference.

Being physically active is also important for keeping control of blood glucose levels. The more exercise we do, the better our bodies get at using insulin [xii]. Being active does not have to mean lifting weights or long-distance running. It might be going for a brisk walk or gardening – it is all about finding something that works for you and your lifestyle.

 

Sources:
[i] The Journey towards building engaging dietary resources for BAME communities https://www.diabetesonthenet.com/journals/issue/567/article-details/journey-towards-building-engaging-dietary-resources-bame-communities Last accessed 5th November 2020

[ii] The Journey towards building engaging dietary resources for BAME communities https://www.diabetesonthenet.com/journals/issue/567/article-details/journey-towards-building-engaging-dietary-resources-bame-communities Last accessed 5th November 2020

[iii] Diabetes UK Funds BAME research. Available at: https://www.diabetes.org.uk/about_us/news/diabetes-uk-funds-47-million-bame-research#:~:text=Diabetes%20UK%20has%20so%20far,data%20released%20by%20the%20charity. Last accessed 5th November 2020

[iv] Diabetes Q& A on ethnicity. Available at ; https://diabetes-resources-production.s3-eu-west-1.amazonaws.com/diabetes-storage/migration/pdf/Questions-and-answers-Winter2016.pdf Last accessed 5th November 2020

[v] NHS Diabetes conditions. Available at : https://www.nhs.uk/conditions/diabetes/ Last accessed 5th November 2020

[vi] Diabetes Q& A on ethnicity. Available at ; https://diabetes-resources-production.s3-eu-west-1.amazonaws.com/diabetes-storage/migration/pdf/Questions-and-answers-Winter2016.pdf Last accessed 5th November 2020

[vii] Diabetes Q& A on ethnicity. Available at ; https://diabetes-resources-production.s3-eu-west-1.amazonaws.com/diabetes-storage/migration/pdf/Questions-and-answers-Winter2016.pdf Last accessed 5th November 2020

[viii] Diabetes UK Funds BAME research. Available at: https://www.diabetes.org.uk/about_us/news/diabetes-uk-funds-47-million-bame-research#:~:text=Diabetes%20UK%20has%20so%20far,data%20released%20by%20the%20charity. Last accessed 5th November 2020

[ix] The journey towards building engaging dietary resources – BAME. Available at: https://www.diabetesonthenet.com/journals/issue/567/article-details/journey-towards-building-engaging-dietary-resources-bame-communities Last accessed 5th November 2020

[x] Diabetes UK – Healthy Food Swops. Available at: https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/healthy-swaps Last accessed 5th November 2020

[xi] American Diabetes Association – Blood Sugar and exercise. Available at https://www.diabetes.org/fitness/get-and-stay-fit/getting-started-safely/blood-glucose-and-exercise#:~:text=Insulin%20sensitivity%20is%20increased%2C%20so,insulin%20is%20available%20or%20not. Last accessed 5th November 2020