Sugumar V, Zhu Y, Doshi T, Wadhwani A, Akanbi E, Yusuf Ibrahim A, Joy T, Clemens KK. Specialist-led interventions to support equity-deserving populations with diabetes: A scoping review of the literature. World J Diabetes 2026; 17(8): 120392 [DOI: 10.4239/wjd.120392]
Corresponding Author of This Article
Kristin K Clemens, Department of Medicine, Division of Endocrinology and Metabolism and Department of Epidemiology and Biostatistics, Western University, 268 Grosvenor Street PO BOX 5777, STN B, London N6A 4V2, Ontario, Canada. kristin.clemens@sjhc.london.on.ca
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Sugumar V, Zhu Y, Doshi T, Wadhwani A, Akanbi E, Yusuf Ibrahim A, Joy T, Clemens KK. Specialist-led interventions to support equity-deserving populations with diabetes: A scoping review of the literature. World J Diabetes 2026; 17(8): 120392 [DOI: 10.4239/wjd.120392]
World J Diabetes. Aug 15, 2026; 17(8): 120392 Published online Aug 15, 2026. doi: 10.4239/wjd.120392
Specialist-led interventions to support equity-deserving populations with diabetes: A scoping review of the literature
Vithuyan Sugumar, Yunxu Zhu, Tanya Doshi, Arpana Wadhwani, Emmanuel Akanbi, Aisha Yusuf Ibrahim, Tisha Joy, Kristin K Clemens
Vithuyan Sugumar, Tanya Doshi, Arpana Wadhwani, Schulich School of Medicine and Dentistry, Western University, London N6A 4V2, Ontario, Canada
Yunxu Zhu, Kristin K Clemens, Lawson Research Institute, London N6A 4V2, Ontario, Canada
Emmanuel Akanbi, Department of Epidemiology and Biostatistics, Western University, London N6A 4V2, Ontario, Canada
Aisha Yusuf Ibrahim, Tisha Joy, Department of Medicine, Division of Endocrinology and Metabolism, Western University, London N6A 4V2, Ontario, Canada
Kristin K Clemens, Department of Medicine, Division of Endocrinology and Metabolism and Department of Epidemiology and Biostatistics, Western University, London N6A 4V2, Ontario, Canada
Author contributions: Sugumar V contributed to the study concept, identified studies, interpreted data and drafted the manuscript; Zhu Y contributed to the concept, identified studies, interpreted data and drafted the manuscript; Doshi T contributed to the concept, identified studies, interpreted data and drafted the manuscript; Wadhwani A, Yusuf Ibrahim A and Joy T interpreted the results and reviewed the manuscript; Clemens KK contributed to the concept, design, identification of studies, result interpretation and she edited the manuscript.
Conflict-of-interest statement: There are no conflicts of interest to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Kristin K Clemens, Department of Medicine, Division of Endocrinology and Metabolism and Department of Epidemiology and Biostatistics, Western University, 268 Grosvenor Street PO BOX 5777, STN B, London N6A 4V2, Ontario, Canada. kristin.clemens@sjhc.london.on.ca
Received: February 26, 2026 Revised: March 30, 2026 Accepted: July 9, 2026 Published online: August 15, 2026 Processing time: 161 Days and 2.9 Hours
Abstract
BACKGROUND
Diabetes mellitus (DM) has a disproportionate impact on populations who also face barriers to specialist diabetes care (e.g., racialized people, those of lower socioeconomic status).
AIM
To identify specialist-led interventions to support the care of equity-deserving populations with DM.
METHODS
Using the Joanna Briggs Institute framework, we conducted a scoping review of the medical and grey literature to the spring of 2024. Equity deserving communities of interest included those of low socioeconomic status, people living in rural regions, sex and gender minorities, racialized people, people with disability, migrants, individuals experiencing homelessness, and Indigenous peoples. We aimed to understand the impact of specialist-led interventions on DM-related screening [e.g., glycated hemoglobin (HbA1c)] and outcomes (e.g., hospitalizations for DM complications).
RESULTS
Our broad search identified 1963 citations: 178 underwent full-text screening, and 28 papers met inclusion. Five major types of interventions were identified: (1) Provider education programs; (2) Patient education programs; (3) Community supports; (4) Multidisciplinary clinics; and (5) Telehealth. The impact of interventions on HbA1c was most often studied, followed by the adoption of lifestyle changes and use of cardiovascular- and kidney-protective medications. Patient and provider “empowerment”, the inclusion of multiple health disciplines, attention to the social determinants, and use of virtual tools appeared to be key components of program success. Stakeholder “buy-in” and devoted resourcing were also important.
CONCLUSION
Specialist DM care can be re-designed to support equity-deserving patients. Future studies could investigate the practicality, feasibility, sustainability, and economic impact of new care models across different healthcare settings and contexts.
Core Tip: Diabetes disproportionately affects equity-deserving populations, yet access to specialist care remains limited. This scoping review synthesizes evidence on specialist-led and specialist-supported diabetes interventions in high-income countries, identifying five effective care models: Provider education, patient education, community supports, multidisciplinary clinics, and telehealth. Patient and provider empowerment, interdisciplinary collaboration, attention to social determinants of health, and flexible delivery appear important to program success. Models that extend specialist expertise into primary care and community settings may overcome structural barriers to access. Our findings can inform equitable, scalable diabetes care design and future implementation-focused research.
