A perspective piece on Diabetes Self-Management Education and Support (DSMES) programmes for under-represented groups with T2DM in the UK

Self-management is critical for optimisation of diabetes care, and diabetes self-management education and support (DSMES) programmes are well recognised to improve biomedical, behavioural and psychological outcomes for people living with diabetes. The aim of this perspective piece is (1) to delineate the barriers experienced by under-represented groups with type 2 diabetes mellitus (T2DM) and (2) to evaluate the role of targeted interventions and digital health as potential solutions to address these barriers and bridge the gaps in diabetes care. Common barriers to accessing DSMES programmes include practical issues such as timing and location, as well as psychological barriers such as stigma. Available evidence shows that tailoring diabetes self-management programmes to fit with people’s culture or specific needs increases effectiveness and acceptability of DSMES programmes in seldom heard groups. Digital-based self-management programmes have the opportunity to reach a vast number of individuals and offer an alternative source to empower people with T2DM. However, technology may also widen health inequalities and increase social isolation. Therefore, further research is required to establish bespoke and effective diabetes self-management programmes for under-represented individuals with T2DM.