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Journal of Diabetes Research
Volume 2016 (2016), Article ID 8030627, 15 pages
http://dx.doi.org/10.1155/2016/8030627
Review Article

Meeting the Challenge of Diabetes in Ageing and Diverse Populations: A Review of the Literature from the UK

1Institute for Health Research, University of Bedfordshire, Luton, UK
2Foundation for Diabetes Research in Older People, Diabetes Frail, Droitwich, UK

Received 15 April 2016; Revised 12 September 2016; Accepted 20 September 2016

Academic Editor: Gill Rowlands

Copyright © 2016 Emma Wilkinson et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The impact of type 2 diabetes on ageing societies is great and populations across the globe are becoming more diverse. Complications of diabetes unequally affect particular groups in the UK older people, and people with a South Asian background are two population groups with increased risk whose numbers will grow in the future. We explored the evidence about diabetes care for older people with South Asian ethnicity to understand the contexts and mechanisms behind interventions to reduce inequalities. We used a realist approach to review the literature, mapped the main areas where relevant evidence exists, and explored the concepts and mechanisms which underpinned interventions. From this we constructed a theoretical framework for a programme of research and put forward suggestions for what our analysis might mean to providers, researchers, and policy makers. Broad themes of cultural competency; comorbidities and stratification; and access emerged as mid-level mechanisms which have individualised, culturally intelligent, and ethical care at their heart and through which inequalities can be addressed. These provide a theoretical framework for future research to advance knowledge about concordance; culturally meaningful measures of depression and cognitive impairment; and care planning in different contexts which support effective diabetes care for aging and diverse populations.