Academic journal article Generations

Diabetes in Older Hispanic/ Latino Americans: Understanding Who Is at Greatest Risk

Academic journal article Generations

Diabetes in Older Hispanic/ Latino Americans: Understanding Who Is at Greatest Risk

Article excerpt

Older Hispanics are at greater risk for type 2 diabetes than non-Hispanic whites. This disease poses a greater burden for this cohort, and more research and interventions are needed to lessen this disparity.

The epidemic of type 2 diabetes is a major health and social problem, affecting more than 29 million people in the United States (Centers for Disease Control and Prevention [CDC], 2014). Type 2 diabetes is defined by the American Diabetes Association (ADA) as a condition characterized by hyperglycemia resulting from the body's inability to use blood glucose for energy. In type 2 diabetes, the pancreas is no longer able to provide enough insulin and also the body is unable to use it correctly (ADA, 2013).

Type 2 diabetes develops through a combination of genetic risk factors (family history), non-modifiable risk factors (such as age, race, or ethnicity), and modifiable risk factors (such as obesity and smoking). With age, the disease process becomes more complicated, as there are changes in body composition (gaining body fat, losing muscle), metabolism (less calories burned), and function (less physically active). Furthermore, type 2 diabetes in older adults can be long-standing (diagnosed before age 65) or new onset (at any age), resulting in an increased prevalence in this age group, and while it can be reversed or controlled, there is no cure for it.

The Office of Minority Health in the Department of Health and Human Services (HHS) offers epidemiological data on diabetes in Hispanics, based on national examination surveys (HHS, 2014). The report describes Hispanics as almost twice as likely to be diagnosed with diabetes when compared with non-Hispanic whites. Older Hispanics with diabetes are a vulnerable sub-population of interest because of their increased susceptibility to chronic diseases like obesity, diabetes, and hypertension (American Heart Association [AHA], 2014), health disparities, and challenges for management. Moreover, with Hispanics being the second largest ethnic minority in the United States (at 53 million, or 17 percent) and one of the fastest growing (U.S. Census Bureau, 2013), the study of diabetes in this population is crucial.

Are Disparities in Diabetes Risk Dependent Upon Place of Birth?

The ADA reports the rates of diagnosed diabetes by race or ethnic background. While only 7.6 percent of non-Hispanic whites and 9 percent of Asian Americans have diabetes, 12.8 percent of Hispanics have diabetes. Other high-risk ethnic groups are non-Hispanic blacks (13.2 percent) and American Indians/Alaskan Natives (15.9 percent). There are further differences among Hispanic adults. For Hispanics living in the United States, the prevalence for type 2 diabetes is lower in those coming from Central and South America (8.5 percent) or Cuba (9.3 percent), but higher for those who are Mexican American (13.9 percent) and Puerto Rican (14.8 percent), who comprise the majority of Hispanic immigrants in the United States.

Diabetes prevalence in Latin American countries also has been studied. A landmark survey of a representative sample (10,587 subjects) of Hispanic/Latinos living in seven Latin American countries, found that selfreported diabetes varied markedly among the older adult population (Barceló et al., 2006). Mexico D.F. (Mexico) and Bridgetown (Barbados) presented the highest prevalence of diabetes (22.3 percent and 18.6 percent, respectively), while Havana (Cuba) and Santiago (Chile) showed the lowest (7.3 percent and 11.9 percent, respectively). These differences, and the very high prevalence described in certain cities, are quite striking. Why do these differences exist and how can they be explained?

As mentioned above, type 2 diabetes develops through a combination of genetic risk background, weight history through life, and non-modifiable and modifiable risk factors. Therefore, older Hispanics are at higher risk just by being older and Hispanic. Studies have found the diabetes prevalence is higher in areas where the majority of people are black (e. …

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