Precision Medicine Starts Here: Recognizing and Supporting Disability in Diabetes Care and Education

Disability is the largest minority group in the United States (more than 1 in 4 people), a group that a person can join at any time. 1 People with disabilities experience significant health disparities and are at least twice as likely to develop diabetes.2 Although not everyone with diabetes considers themselves disabled, diabetes is a federally protected disability under the Americans with Disabilities Act of 1990.3 Despite this, diabetes care and education remain largely designed for people without disabilities, leaving those at the intersection of diabetes and disability underserved.This article provides diabetes care and education specialists (DCESs) with practical, evidence-based insights and resources to deliver disabilitycompetent diabetes self-management education and support (DSMES) and advance precise, accessible, and person-centered care.It highlights the limited practice research at this intersection, resulting in opportunities that the gap creates, and presents a case study demonstrating how recognizing disability can reshape diagnosis, treatment, and DSMES plans.Precision Medicine at the Intersection of Diabetes and Disability Precision medicine uses an individual's genetic, environmental, and lifestyle profiles to guide prevention and treatment decisions.4-8 For people living with both diabetes and disability, precision begins with an accurate diagnosis of both diabetes and disability and an understanding of how disabilities shape the self-management of diabetes.Disability is not a comorbidity to be