SUMMARY Diabetes is pervasive, exponentially growing in prevalence, and outpacing most diseases globally. This article uses new theoretical frameworks and narrative review of existing literature to demonstrate how structural inequity (structural racism and geographic inequity) has accelerated rates of diabetes disease, morbidity, and mortality globally. We discuss how structural inequity leads to large fixed differences in key upstream social determinants of health that influence downstream determinants and diabetes outcomes in a cascade of widening inequity. We detail downstream determinants of health that have known effects on diabetes outcomes, including public awareness and policy, economic development, access to high-quality care, innovations in diabetes treatments, and sociocultural norms. We also provide regional perspectives, grounded in our theoretical framework, to highlight remaining prominent and real-world challenges. It is vital that the social and medical factors discussed in this article be acknowledged, understood, and incorporated into future efforts to curb the global diabetes crisis.
【저자키워드】 Type 1 diabetes, diabetes, global health, type 2 diabetes, social determinants of health, inequalities, Structural racism, Social factors, geographic inequity, racial inequity, structural inequity,