Background: Ethnic minority groups in upper-middle-income and high-income-countries tend to be socioeconomically disadvantaged and have a higher prevalence of type 2 diabetes mellitus (T2DM) that is seen in the majority population. The purpose of this systematic review of the literature is to examine the effectiveness of interventions for the prevention of T2DM in the Arab ethnic minority group, which is considered high risk.
Methods: The research questions in this systematic review were defined using the five PICOS; Population, Intervention, Comparators, Outcome and Study Design. The studies included in this review included participants aged over 18 who are at risk of diabetes and do not have any known complex diseases that may influence the outcomes of this study; such as cancers, heart disease, genetic disorders. Interventions included behavioural and lifestyle interventions; combining both physical activity and dietary modifications or either separately and excluded pharmacological interventions.
Results: A variety of outcome measures were used by the various trials; diabetes-related biochemical blood values (HbA1c levels, lipid levels, blood glucose levels); results of validated attitudinal and behavioural questionnaires; knowledge of different diabetes-related topics; health related quality of life measures, weight, body mass index (BMI) or waist-to-hip ratios, and blood pressure measurements.
Conclusions: Culturally appropriate interventions have short-to-medium term effects of glycaemic control and on knowledge of diabetes and healthy lifestyles. None of the studies included in this review were long-term trials and so clinically important long-term outcomes could not be studied. No studies included an economic analysis. The heterogeneity of the studies makes subgroup comparisons difficult to interpret with confidence. Long-term, standardised RCTs are needed to compare the different types and intensities of culturally appropriate health education within defined ethnic minority groups, as the medium term effects could lead to clinically important health outcomes, if sustained.
This systematic review is the first to explore the effectiveness of prevention programmes in the Arab ethnic minority group. The systematic review may also identify specific gaps in the evidence which would inform agenda for future research and policy.
Keywords: Diabetes mellitus, type II diabetes, type 2 diabetes, Arab, prevention programme, interventions, T2D
12 Sep 2019 - 13 Sep 2019