Cultural and language barriers may be hindering the treatment of South Asians with diabetes

Cultural and language barriers may be hindering the treatment of South Asians with diabetes, recently published findings from a University of Edinburgh study show.

South Asians are four times more likely than the rest of the UK population to have the condition. A follow up study has now begun into finding our how communication barriers could be overcome in medical consultation.

The study recruited 32 people from within the Pakistani and Indian communities in Edinburgh who had type 2 (maturity onset) diabetes and found that although most patients were generally happy with their treatment, there were specific issues over communication and food.

Researcher Dr Julia Lawton of the Research Unit in Health, Behaviour and Change said: "Diabetes is a complicated disease and its successful management involves the whole family, including those who buy and cook as well as eat the food. Many of the patients were resistant to major dietary changes as they saw the eating of traditional foodstuffs like curries and chapattis as central to the maintenance of their cultural identities. Those in the study also described how refusing hospitality, or eating different foods from other members of the family could cause offence and lead to social isolation."

Dr. Lawton's team also found that it was often hard for Indian and Pakistani diabetics to increase their physical activity. "Many barriers were reported, including time constraints due to working long, anti social hours; perceptions that exercising is an individualistic or selfish act in a culture which prioritises family obligations; constraints on women spending time outside the home and cultural taboos about women exposing their bodies to the opposite sex, such as in swimming pools."

Many of the patients did not speak English as a first language and needed help with interpretations during medical consultations. "We found that many of the patients felt frustrated and constrained at having to rely on other people to interpret, so they left the doctors' consulting rooms with many questions unanswered," said Dr Lawton.

The project will now be followed by a qualitative study of 20 South Asians with Type II diabetes, where a bilingual researcher will interview and observe patients and doctors before, during and after consultations. Results of the study will provide guidance on the use of interpreters in future consultations.

Both projects are funded by the Chief Scientist Office.

o 5% of the annual NHS budget is spent on caring for people with diabetic complications and this figure is set to rise.

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