Culturally appropriate care for indigenous people with type 2 diabetes mellitus (T2DM)- a scoping review

Background

Indigenous populations are disproportionately affected by type 2 diabetes mellitus (T2DM) and associated complications. However, the lack of cultural integration with the current management approach does not suit indigenous communities. Therefore, the aim of this scoping review is to map the existing literature related to culturally appropriate care and to establish the key characteristics of a culturally appropriate care provided to indigenous communities with T2D.

Methods

Electronic databases such as PubMed, CINAHL, Science Direct and Cochrane Library were searched from inception to September 2024. Identified records from database literature searches were imported into Covidence®. Two independent reviewers screened and extracted the data. Studies included Indigenous people with T2D, culturally appropriate care, measurable outcomes, and any design. The research team collectively created a data charting table/form to standardize data collection that included PICO elements and PROGRESS-Plus factors for equity lens. A narrative synthesis was used to summarize the evidence.

Results

Seven studies met our eligibility criteria and were included in this scoping review. Overall, there is clear evidence that a culturally appropriate care results in better physiological outcomes and higher rates of adherence and engagement with a treatment plan and disease management processes. However, future studies need to gather and report on other PROGRESS factors that can cause inequity such as Religion, Education, Socioeconomic status of participants.

Conclusion

The findings of this review emphasise that a culturally appropriate care is crucial in improving health outcomes and engagement among Indigenous people with T2D. However, systemic barriers still exist, highlighting the need for broader structural changes.