Understanding the growing epidemic of type 2 diabetes in the Hispanic population living in the United States

Abstract

The prevalence and incidence of type 2 diabetes (T2D) among the Hispanic population in the United States are higher than the national average. This is partly due to sociocultural factors, such as lower income and decreased access to education and health care, as well as a genetic susceptibility to obesity and higher insulin resistance. This review focuses on understanding the Hispanic population living in the United States from a multidisciplinary approach and underlines the importance of cultural, social, and biological factors in determining the increased risk of T2D in this population. An overview of the acute and chronic complications of T2D upon this population is included, which is of paramount importance to understand the toll that diabetes has upon this population, the health system, and society as a whole. Specific interventions directed to the Hispanic populations are needed to prevent and alleviate some of the burdens of T2D. Different prevention strategies based on medications, lifestyle modifications, and educational programmes are discussed herein. Diabetes self-management education (DSME) is a critical element of care of all people with diabetes and is considered necessary to improve patient outcomes. To be more effective, programmes should take into consideration cultural factors that influence the development and progression of diabetes. These interventions aim to enhance long-term effects by reducing the incidence, morbidity, and mortality of T2D in the Hispanic population of the United States.

Keywords: Hispanics; Latinos; complications; education; epidemiology; pathophysiology; prevention; type 2 diabetes.

Conflict of interest statement

CONFLICT OF INTEREST

The authors have no conflict of interest to declare.

© 2018 John Wiley & Sons, Ltd.

Figures

FIGURE 1

Demographics of Hispanics living in the United States. A, Percentage of Hispanics out of the total US population. B, Rates of uninsurance among Hispanics and non-Hispanic white (NHW). C, Comparison of education levels between Hispanics living in the United States and NHW

FIGURE 2

Diabetes-related mortality. A, Top causes of mortality in Mexico based on World Health Organization (WHO) data. B, Mortality from type 2 diabetes (T2D) in Latin American countries relative to the United States. Data obtained from WHO

FIGURE 3

Socio-economic and pathophysiological factors contributing to the development of type 2 diabetes in Hispanics living in the United States. Both genetic, metabolic, socio-economic, and environmental factors play a role in the known sequence of pathophysiological events that lead to the development of diabetes in the Hispanic population. Arrows are proven directional events that lead or increase the risk of type 2 diabetes (T2D) development