By Jennifer O’Mann
Over 30 million people in America have diabetes, and around a third of the national population has pre-diabetes. As alarming as these numbers are, they are even more so for the LGBTQI+ community, whose members have a higher risk of this disease owing to stigma and other barriers to proper care. A 2018 study by L Beach and colleagues showed that gay and bisexual men were more likely to report a lifetime diabetes diagnosis than heterosexual men. Similar percentages were reported for lesbian and bisexual women. Why are members of the LGBTQI+ community at a greater risk of diabetes, and why is more culturally sensitive care and greater awareness required to correct healthcare disparities?
Reasons For Increased Diabetes Percentages Among Members Of The LGBTQI+ Community
Beach and colleagues reported that LGBTQI+ populations have several reasons for having a higher risk of diabetes. These include the fact that they are more likely to smoke and consume alcohol heavily than their heterosexual counterparts. Additionally, the use of medication to treat conditions such as HIV, hypertension, and some mental health conditions is also linked to higher diabetes percentages. Depression, risk taking, and stigma – all of which are higher in this group – are also linked to a higher rate of diabetes. A final risk factor occurs when health care workers display prejudice or make erroneous assumptions about their patients.
Higher BMIs And Diabetes
Studies have also shown that gay men are less likely (while lesbian and bisexual women are more likely) to have a body mass index (BMI) of 30kg/m2 or higher than heterosexuals. Having a high BMI is linked not only to diabetes, but also to associated complications – including nerve damage or diabetic neuropathy. People with diabetes often wear compression socks for nerve damage, which can lead to the loss of legs, toes and feet. People with diabetic neuropathy can have a loss of feeling in these zones, which can lead to higher infection rates when cuts and sores occur. Diabetic neuropathy is also linked to UTIs, blood pressure drops, digestive issues, and other symptoms.
Improved Care And Awareness Are Required
Several bodies of research have shown that the LGBTQI+ community faces many challenges when it comes to receiving health care for diabetes. Theresa Garnero and colleagues report, for instance, that LGBTQI+ health data is often omitted from mainstream science. For instance, lesbians have the highest rate of polycystic ovarian syndrome, yet this is not even mentioned in articles on this condition on two of the most read diabetes online sites. There are also concerns regarding how patients are treated. LGBTQ+ diabetes support groups have reported, for instance, that lesbians often have to argue with health care providers who do not believe they do not have a chance of being pregnant. Others report that their relationship is often ignored – for instance, when they mention the role their partner plays in motivating them to keep their blood glucose at healthy levels. Still others find that it can be difficult to find LGBTQ+-friendly certified diabetes educators.
Including The Need For Culturally Sensitive Care At The Educational Stage
Garnero and colleagues report that improved cultural sensitivity begins with including LGBTQ+-centered needs in medical school curricula. It is important for health care providers to be aware of the specific norms and experiences that shape patients’ lives. Forms, interviews, and educational materials should not assume heterosexuality. Moreover, inclusive language (such as ‘partner’ instead of ‘husband’ or ‘wife’) should be used. Health providers should freely discuss the result of research on LGBTQ+ disparities to enable patients to feel more secure about discussing their circumstances and receiving truly useful, bespoke advice. Asking about aspects such as appropriate pronouns can additionally help patients to feel more comfortable.
Members of the LGBTQ+ community have a higher risk of diabetes. They are also less likely to receive due diagnosis and treatment owing to factors such as stigma and inadequate service from health care providers. As a whole, improvements need to be made to boost education and awareness among medical providers so that diagnoses and treatments are based on asking the right questions instead of making assumptions.
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