Building cultural competency for improved diabetes care: African Americans and diabetes.

For decades, it has been assumed that the nature and art of medicine automatically embrace an unbiased approach to maintaining health and life. Current data show this is not the case. An estimated 3.2 million African Americans--comprising 13.3% of the African American population in the United States--aged 20 years and older currently have type 2 diabetes mellitus (T2DM). Among this group, a third are undiagnosed. To start addressing the "why and how," we must examine and address the underlying problem of disconnection. This is a repurposed word used to introduce the concept of "barrier." As it relates to the African American patient and T2DM, a disconnection exists on several levels, including health beliefs, nutritional practices, religious beliefs and practices, interactions with the health care system, and socioeconomic issues. Being aware of these factors and being prepared to assess and treat the African American patient with respect and compassion is the best way to make a positive impact on the devastating epidemic of T2DM.