Barriers and effective interventions associated with diabetes management among the East Asian immigrant population: A...

The prevalence of diabetes has rapidly increased for East Asian immigrant populations, exceeding rates in East Asian populations in their home countries and the general population of host countries. The increased risk highlights the complex interplay between genetic predisposition and socio-cultural environmental factors associated with migration. Managing diabetes and navigating unfamiliar healthcare systems are challenging for immigrant populations underscoring the need for research on barriers and effective targeted strategies.

Identify barriers to best diabetes management practices and effective interventions among East Asian immigrant populations.

Studies were identified through PUBMED, OVID MEDLINE, CINAHL COMPLETE and SCOPUS databases utilising Arksey and O'Malley's framework. Peer-reviewed, English reports between January 2010 and August 2024 relating to challenges and barriers of best management practices among adult East Asian immigrants and interventions that facilitated management were identified. Studies of people with type 1 or gestational diabetes and those <18 years old were excluded.

Of 576 articles screened, 18 studies meeting the criteria were included in this review. Twelve studies included Chinese immigrants, 13 studies were from the United States, including six among American-Korean immigrants, three were from Australia and two from Canada. Barriers to best diabetes management practices identified from observational studies were themed as relating to (1) 'Cultural Views' (diabetes, diet, medication, traditional remedies, health professional hierarchy and family roles); (2) 'Immigration Challenges' (communication, communication, transport, financial, time constraints, emotional distress and dissatisfaction with Western healthcare systems). Randomised controlled trials (n = 2) and single-group trials (n = 6) reported on effective interventions that improved self-management and/or cardiometabolic risk factors, focusing on self-management (n = 3), nutritional (n = 4) and social media (n = 1) educational programmes.

Barriers to best diabetes management practices included clashes with cultural views, immigration-related challenges and dissatisfaction with Western healthcare systems. Effective interventions were mostly associated with culturally-tailored, didactic and bilingual diabetes education programmes.