Personalized lifestyle modifications for improved metabolic health: The role of cultural sensitivity and health communication in type 2 diabetes management

Type 2 Diabetes (T2D) is a chronic multifaceted metabolic condition characterized by elevated blood glucose levels with varying degrees of insulin resistance and abnormal insulin production. Lifestyle modifications, such as those defined by the guidelines for diabetes self-management education and support (DSMES), are foundational for glycemic control. A current gap in T2D management is addressing DSMES which is tailored to best serve the diversity of patients with this disease. The purpose of this narrative review is to discuss the current literature related to lifestyle modification for T2D, the importance of culturally sensitive T2D management programs, and the impact culturally sensitive and diverse T2D management programs have on cardiometabolic health. Despite being disproportionately affected by T2D, racial and ethnic minorities have low referral rates for DSMES. This growing disparity may be exacerbated by a lack of awareness of how to adapt lifestyle modifications in a culturally competent manner and how social determinants of health (SDOH) may affect the infrastructure and resources available to diverse patient populations. Currently, there is limited research on how DSMES is addressed to include culturally and literacy-sensitive recommendations in the United States. Patient-centered care, emphasizing personalized DSMES, can lead to improved glycemic control, reduced healthcare costs, and improved cardiometabolic health. A key component of effective DSMES should include culturally and literacy-sensitive approaches with an awareness of the impact of SDOH. Understanding how ethnicity, race, and culture influence experiences with T2D management can help providers prescribe more patient-centered and sustainable recommendations. A key component of Type 2 Diabetes (T2D) management is a combination of lifestyle and behavioral modifications, such as those defined by the guidelines for diabetes self-management education and support (DSMES). Patient-centered care with an emphasis on DSMES may result in improved and sustained glycemic control, reduced healthcare costs, and improved quality of life; however, racial/ethnic minority groups, who already share a disproportionate burden of diabetes risk, diagnosis, and complications, experience proportionally low rates of referral for DSMES.Cultural nuances do, and should, influence DSMES recommendations. Contextualizing and addressing the unique cultural needs and preferences for individual diabetes patients is vital for promoting optimal care and outcomes.Diabetes providers should understand how social determinants of health (SDOH) and factors such as context, community, and communication, may affect the infrastructure and resources available to diverse patient populations for self-management.Patient-centered diabetes care that appreciates the influence of cultural and SDOH factors may result in more effective DSMES, and providers should be aware of when and how to adapt DSMES for diverse patients leveraging cultural competency and humility skills at the point of care.