Precision diabetes medicine and health equity: a scoping review

Abstract Aims/hypothesis Precision diabetes medicine aims to improve the accuracy of prevention and treatment by tailoring care to individuals and subgroups. When applied appropriately, it can reduce health disparities in diverse populations; however, it may also exacerbate disparities if inequities in research or implementation persist. This review sought to: (1) assess how health equity and disparities have been examined in precision diabetes medicine research; (2) identify which aspects are most frequently addressed; and (3) synthesise the conclusions drawn. Methods A scoping review was conducted in PubMed and Embase, supplemented by a retrospective citation search. No filter was applied for publishing date; however, studies were limited to those written in English and the review period concluded on 6 May 2025 in Embase and on 4 May 2025 in PubMed. Full articles of all study types were included if they discussed precision diabetes medicine from a health equity perspective. Data charting was primarily performed through the extraction of verbatim quotes relating to health disparities, barriers, opportunities and actionable solutions to enhance equity. Results Of 182 articles identified, 34 met inclusion criteria. The most common determinant of disparities discussed was race or ancestry ( n = 30). Frequently cited barriers included uneven representation of ancestries in research ( n = 24), limited attention to social determinants of health ( n = 7) and high costs restricting access ( n = 18). Suggested solutions included inclusion of under-represented groups ( n = 15), greater focus on social determinants ( n = 8) and enhanced patient and public involvement ( n = 8). Opportunities for improving equity included leveraging new technologies ( n = 9) and real-world data ( n = 5). Conclusions/interpretation The need to promote health equity in precision diabetes medicine is increasingly acknowledged, with achievable priorities including broader inclusion, and attention to social determinants of health and cost-effectiveness. Registration PROSPERO registration ID CRD420251033223.