Achieving Equity in Diabetes Research: Borrowing From the Field of Quality Improvement Using a Practical Framework and Improvement Tools

The incidence and prevalence of diabetes have been steadily increasing (1,2). The burden of disease is more significant for minoritized communities, including Hispanic, non-Hispanic Black, Asian American, and Native American people (2,3). There are widespread inequities in access to care, use of technology, and outcomes for people with diabetes (3–7). Unfortunately, the coronavirus disease 2019 pandemic has amplified these inequities (8–11).

Research and clinical trials are valuable to determine the effectiveness, safety, and acceptability of clinical interventions and drugs that have the potential to promote equity in a host of outcomes (12). However, minoritized communities are less likely to be represented in diabetes research (13–17). Thus, opportunities are lost to include and tailor approaches to underserved populations to help increase equity or achieve more generalizable outcomes outside of traditionally recruited research cohorts. Regulatory bodies and journals do not mandate or enforce the representation of minorities in research, so most trials do not prioritize diverse recruitment (18,19). Moreover, a legacy of unethical research practices contributes to distrust and low participation in medical research among minoritized communities that remain unaddressed (20).

The diabetes research field would benefit from reframing race/ethnicity as a social construct with historical and structural considerations and developing tools to make representation and interventions equitable. To date, there is limited literature on practical tools to guide researchers in making diabetes research more equitable. This publication aims to describe how a practical equity framework, developed using quality improvement (QI) principles and multidisciplinary stakeholders, can increase equity, diversity, and inclusion in diabetes clinical research to improve outcomes for all people with diabetes.

https://diabetesjournals.org/spectrum/article/35/3/304/147390/Achieving-Equity-in-Diabetes-Research-Borrowing