Implementation advice: health inequalities in type 2 diabetes
Low uptake of SGLT-2 inhibitors
Sodium–glucose cotransporter-2 (SGLT-2) inhibitors such as dapagliflozin are under-prescribed to some groups of people who are eligible for them. This includes women, older people, people from some ethnic backgrounds and people living in the most deprived areas.
Why this matters
If prescribing practices are not equitable, people with the highest risk of complications may not have access to the protective benefits of SGLT-2 inhibitors.
What you can do
Actions for providers and healthcare professionals
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Improve data quality by consistently recording ethnicity, disability and preferred language using systematised nomenclature of medicine clinical terms (SNOMED CT) codes.
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Strengthen decision making by adding clinical prompts and decision-support tools into clinical systems.
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Engage with culturally diverse communities by working closely with local voluntary community services (VCS), social prescribing teams, and co-designing services with communities that have low uptake.
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Develop the workforce by accessing training, particularly around cultural differences, trauma-informed care and medicines optimisation.
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Improve engagement with routine diabetes care by encouraging people to attend their annual review, using review data to optimise treatment plans.
Actions for commissioners
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Improve data quality by supporting providers to improve and standardise the recording of ethnicity, disability and preferred language using SNOMED codes.
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Strengthen clinical decision making by providing support to build clinical prompts and decision-support tools.
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Engage with culturally diverse communities by funding co-designed services and leading engagement initiatives.
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Develop the workforce by supporting access to training that promotes equitable prescribing.
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Monitor prescribing and care-process data by reviewing variation at system, place, and practice level, identifying where further support is needed.
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