Lay summary
Type 2 diabetes (T2D) affects more than 250,000 New Zealanders, including a disproportionate number of Pacific peoples because of colonialism, an under-represented workforce and other ongoing barriers. Importantly, many patients with T2D are sub-optimally managed in primary care, and thus develop diabetes-induced renal and/or cardiovascular disease (T2DR/CVD). This creates some of the greatest inequities, with Pacific peoples being more likely than non-Pacific to develop T2D- induced CVD and/or renal disease. Much of the inequity in diabetes management in primary care stems from clinical inertia and variation in prescribing behaviours, with Pacific peoples less likely to receive optimal medications. This variation is important to address, particularly with the recent funding approval of the new diabetes medications empagliflozin and dulaglutide which have the potential to significantly improve health outcomes in those with T2DR/CVD. It is also imperative that we identify practice-level factors that contribute to the under-prescribing in Pacific.