Among East Asian Americans (EAAs) (populations from China, Korea, Japan, and Taiwan), type 2 diabetes mellitus (T2DM) is largely underreported and underdiagnosed; and therefore, unmanaged. Many EAAs are first generation immigrants with traditional cultural beliefs and norms, and language barriers that influence poor T2DM self-management. This mixed-study review aims to identify and examine cultural perspectives of EAAs and culturally tailored approaches that influence dietary self-management of diabetes.

Design/Methods:

A total of 688 articles were retrieved for screening; 10 qualitative and 6 quantitative articles were identified for the review. Thematic synthesis of qualitative data conducted using a line-by-line coding. Tailored intervention approaches and outcomes in the quantitative studies (experimental design) were extracted and assessed.

Results:

EAA’s beliefs about food impacted their ability to adopt appropriate dietary recommendations for self-management of T2DM. Requiring a special diet disrupted social harmony and made EAAs feel burdensome to others. Having bilingual and bicultural resources eased the stress of making dietary modifications. All interventions incorporated bilingual and bicultural diabetes education and culturally specific dietary recommendations for EAAs. Most intervention studies reported a significant reduction in HbA1c and significant increase in diabetes knowledge post-intervention.

Conclusions:

Beliefs about food, beliefs about social roles, and access to culturally competent, bilingual care play important roles in dietary self-management of T2DM among EAAs. Understanding the cultural influences, including beliefs and barriers, on dietary self-management of T2DM among EAAs and tailoring interventions to meet the needs of EAAs is essential in effort to address the growing epidemic and improve patient outcomes.