Major ethnic disparities in diabetes care, especially for intermediate outcomes and diabetes complications, were evident prior to the coronavirus disease 2019 (COVID-19) pandemic. Diabetes is a risk factor for severe COVID-19, and the combination of these ethnic disparities in diabetes care and outcomes may have contributed to the inequity in COVID-19 outcomes for people with diabetes. Overall, ethnic minority populations have suffered disproportionate rates of COVID-19 hospitalization and mortality. Results from the limited number of studies of COVID-19 in ethnic minority populations with diabetes are mixed, but there is some suggestion that rates of hospitalization and mortality are higher than those of White populations. Reasons for the higher incidence and severity of COVID-19–related outcomes in minority ethnic groups are complex and have been shown to be due to differences in comorbid conditions (e.g., diabetes), exposure risk (e.g., overcrowded living conditions or essential worker jobs), and access to treatment (e.g., health insurance status and access to tertiary care medical centers), which all relate to long-standing structural inequities that vary by ethnicity. While guidelines and approaches for diabetes self-management and outpatient and inpatient care during the pandemic have been published, few have recommended addressing wider structural issues. As we now plan for the recovery and improved surveillance and risk factor management, it is imperative that primary and specialist care services urgently address the disproportionate impact the pandemic has had on ethnic minority groups. This should include a focus on the larger structural barriers in society that put ethnic minorities with diabetes at potentially greater risk for poor COVID-19 outcomes.

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COVID-19 疫情对少数族裔糖尿病患者的影响

在 2019 年冠状病毒病 (COVID-19) 大流行之前，糖尿病护理方面的主要种族差异，特别是中间结果和糖尿病并发症方面的差异，就很明显。糖尿病是严重 COVID-19 的危险因素，糖尿病护理和结果方面的这些种族差异可能导致糖尿病患者的 COVID-19 结局不平等。总体而言，少数族裔人口的 COVID-19 住院率和死亡率不成比例。针对患有糖尿病的少数民族人群进行的有限的 COVID-19 研究结果好坏参半，但有一些建议表明住院率和死亡率高于白人人群。少数族裔群体中 COVID-19 相关结果的发病率和严重程度较高的原因很复杂，已被证明是由于合并症（例如糖尿病）、暴露风险（例如过度拥挤的生活条件或基本工人工作）的差异造成的。 ）和获得治疗的机会（例如，健康保险状况和进入三级医疗中心的机会），这些都与因种族而异的长期结构性不平等有关。虽然大流行期间糖尿病自我管理以及门诊和住院护理的指南和方法已经发布，但很少有人建议解决更广泛的结构性问题。当我们现在计划恢复并改进监测和风险因素管理时，初级和专科护理服务必须紧急解决这一流行病对少数族裔群体造成的不成比例的影响。这应包括关注社会中更大的结构性障碍，这些障碍使患有糖尿病的少数民族面临更大的潜在 COVID-19 不良结果风险。