Hispanics form the largest minority group in the U.S, and are twice as likely to have diabetes compared with non-Hispanic whites -- yet a new review highlights that nearly 40% of US Hispanics with diabetes have not been formally diagnosed. Published in Frontiers in Endocrinology ahead of World Diabetes Day on November 14, the study also finds that diabetes prevalence varies widely among different Hispanic heritage groups and in different Latin American countries. The findings indicate that further research and more effective, adaptable interventions are needed to prevent and manage diabetes in Hispanics.
"The prevalence of diabetes continues to increase not only in the U.S., but also in Latin America," says Larissa Avilés-Santa of the National Heart Lung and Blood Institute and one of the study's authors. "The problem is both serious and complex. Although the specific causes of type 2 diabetes (the most common type of diabetes) in Hispanics/Latinos are not completely understood, genetic, biologic, environmental, socioeconomic, lifestyle and cultural factors could be playing different roles in increasing its prevalence and could underlie the differences observed among different Hispanic heritage groups."
The U.S. Census Bureau defines Hispanics (or Latinos) as persons "of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture regardless of race", although this definition is currently being debated. Despite originating from many different Latin American countries, people sometimes assume that they have broadly similar backgrounds. In fact, Hispanics form a hugely diverse group with significant differences in ancestry and culture.
To better understand diabetes in this diverse population, Avilés-Santa and colleagues reviewed scientific studies on diabetes prevalence, causes, treatment and prevention in Hispanics in the U.S. and Latin America.
The researchers found that diabetes prevalence varies widely among different Hispanic heritage groups, as well as between different Latin American countries. Shockingly, studies performed in the U.S. report that nearly 40% of Hispanics with diabetes have not been formally diagnosed and may be unaware of their diabetes, meaning they risk long-term complications.
The review identified several studies that involve lifestyle or pharmacological interventions to prevent or treat diabetes in Hispanics. In many cases, the results are promising, showing that interventions such as exercise or dietary programs can make a significant difference.
Avilés-Santa and colleagues propose strategies to enhance research and clinical interventions to prevent diabetes more effectively in Hispanics/Latinos. For example, the researchers highlight that to make the results of studies in Hispanics more generalizable, the diversity of Hispanic heritage groups and nationalities should be considered. In addition, collaboration among research teams across the continent could improve studies that investigate the causes and prevention of diabetes among Hispanics of different origins.
The authors also highlight that the diversity of socioeconomic, psychosocial and cultural factors among Hispanic heritage groups needs to be considered when designing lifestyle intervention programs. For example, eating habits, and attitudes to health and self-care are intricately linked to someone's culture.
"We need to start designing more effective lifestyle intervention studies for Hispanics/Latinos that incorporate sound understanding of their diverse cultural norms and adapt to their daily life," says Avilés-Santa.
The organizers of World Diabetes Day, which takes place on November 14 each year, aim to help vulnerable groups around the world, such as Hispanics, to increase their access to essential diabetes care and prevention services.
Frontiers in Endocrinology