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Black History Month: Race and Diabetes

JDRF’s Director of Policy and Communications, Hilary Nathan, reflects on the history of race and diabetes.

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October is Black History Month and we’ve been reflecting on the history of race and diabetes, putting the spotlight on racial health inequalities here in the UK.

We know at JDRF UK we have a continuing journey to go on in terms of representation, diversity, and inclusion. Here we set out where we are now and our work going forward.

A history of racism in diabetes

But first the history. Over the last year, I’ve been reading the book ‘Diabetes: A History of Race and Disease’. It’s an unflinching read and demonstrates how history casts a long shadow over diabetes research, care and support.

The book sets out the evidence from primarily a USA perspective, the deeply racist attitudes which excluded many Black people from being diagnosed and treated with diabetes in the first half of the twentieth century.

The author Arleen Tuchman notes that in the 1930s “those with diabetes were still imagined as White and middle class. Ideas which were re-inforced by statistical studies, therapeutic recommendations and the media.”

Over time, this belief was disproved and discredited, but this Black History Month, it’s worth pausing to reflect on the damage such beliefs imposed on Black people living with type 1, just as the discovery of insulin was starting to save mainly white lives.

Continuing racial health inequality in type 1 diabetes

Things have changed in medical research and practice. But here in the UK we are a long way from racial health equality in type 1 diabetes.

According to the National 2021 Paediatric Diabetes Audit, Black children and young people had the lowest usage of insulin pumps (27.4%) compared to White children (40.2%)*. Research published in the Diabetic Medicine Journal in 2021 found that children from ethnic minorities had higher blood glucose levels than white children, lower use of insulin pumps and continuous glucose monitoring systems than white children and that there was an increasing trend over the last six years in health inequalities among children and young people with type 1 diabetes.**

In adults, the National 2021 Diabetes Audit showed that being Black or Asian is a factor in having higher blood glucose (HbA1c) levels.***

We JDRF UK, the NHS and partners all have much work to do address systemic disadvantage and improve treatment access and health outcomes in type 1 diabetes.

JDRF UK’s commitment to diversity and inclusion

JDRF here in the UK and internationally are working on equality, diversity and inclusion across our culture and operations.

JDRF International in the USA have launched a new funding programme to diversify the type 1 diabetes scientific workforce, inviting grant applications from researchers who self-identify as members of under-represented groups.

Here in the UK we are working to include more people from different ethnicities as partners and participants in our funded research programmes.

Our organisational strategy has set goals across research, communications, recruitment and HR practices. Our policy and community engagement team are focusing on a type 1 health equality for all programme.

We haven’t got all the answers yet. We know we have more work and more learning to do by listening and working with Black people living with type 1 diabetes.

We know that we will be judged not by words we put down in blogs or written plans, but by our actions, our culture and our impact.

This Black History Month, we recognise the past with a commitment to changing and improving the work that we do, so that racial health equality in type 1 becomes a reality.

As ever, I’d like to hear thoughts and comments from everyone with lived experience to help us improve our work now and in the future. If you’d like to share your story with us, please drop us a message on one of our social channels or email us at info@jdrf.org.uk.

References

* Data taken from the National Paediatric Diabetes Audit 2021

** Data taken from the Diabetic Medicine Journal

*** Data taken from the National Diabetes Audit, 2020-21