An ethical framework for addressing the differential impact of systemic racism and inequities on type 1 and type 2 diabetes mellitus in youth in the United States.

IF 2.7 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Hormone Research in Paediatrics Pub Date : 2025-09-19 DOI:10.1159/000548527

Camilia Kamoun, Lina Huerta-Saenz, Dorit Koren, Shideh Majidi, Shilpa Mehta, Natalie Nokoff, Elise Schlissel Tremblay, Rebecca M Harris, Rohan Henry, Brynn E Marks, Jennifer K Raymond

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引用次数: 0

Abstract

Background: Inequities in the clinical care and health outcomes of youth and young adults (YYA) with type 1 diabetes mellitus (T1D) and type 2 diabetes mellitus (T2D) are well-established. Systemic and institutional racism and barriers, as well as implicit biases underlie these inequities in the United States.

Summary: This article offers a broad overview and analysis of disparities in clinical care and outcomes among youth and young adults (YYA) with type 1 and type 2 diabetes, framed within an ethical context. We argue that achieving ethical care requires centering assessments of patient and family needs within the realities of their lived experiences, as well as structural barriers and challenges. We examine the impact of structural racism and implicit bias on clinical care and explore how factors such as non-English language communication, literacy, numeracy, nutrition, school nursing services, access to diabetes technology and medications, and insurance disparities influence diabetes management and outcomes. The article concludes with a call to action and concrete recommendations to address and reduce these inequities.

Key messages: Clinicians can play a pivotal role in reducing diabetes-related health care disparities by adopting an ethical approach that centers upon lived experiences of YYA with diabetes thereby identifying opportunities for more equitable care.

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解决系统性种族主义和不平等对美国青少年1型和2型糖尿病的不同影响的伦理框架

背景：患有1型糖尿病（T1D）和2型糖尿病（T2D）的青年和青壮年（YYA）的临床护理和健康结果的不平等是公认的。系统性和体制性的种族主义和障碍，以及隐性偏见是美国这些不平等的根源。摘要：本文在伦理背景下，对1型和2型糖尿病青年和青壮年（YYA）患者的临床护理和预后差异进行了广泛的概述和分析。我们认为，实现道德护理需要集中评估病人和家庭的需求在他们的生活经历的现实，以及结构性障碍和挑战。我们研究了结构性种族主义和隐性偏见对临床护理的影响，并探讨了非英语语言交流、读写能力、计算能力、营养、学校护理服务、获得糖尿病技术和药物以及保险差异等因素如何影响糖尿病管理和结果。文章最后呼吁采取行动并提出具体建议，以解决和减少这些不平等现象。关键信息：临床医生可以在减少糖尿病相关卫生保健差异方面发挥关键作用，通过采用以YYA糖尿病患者的生活经验为中心的道德方法，从而确定更公平护理的机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hormone Research in Paediatrics ENDOCRINOLOGY & METABOLISM-PEDIATRICS

CiteScore

4.90

自引率

6.20%

发文量

审稿时长

4-8 weeks

期刊介绍： The mission of ''Hormone Research in Paediatrics'' is to improve the care of children with endocrine disorders by promoting basic and clinical knowledge. The journal facilitates the dissemination of information through original papers, mini reviews, clinical guidelines and papers on novel insights from clinical practice. Periodic editorials from outstanding paediatric endocrinologists address the main published novelties by critically reviewing the major strengths and weaknesses of the studies.