USA Wellness

Latinos are the fastest growing ethic group in the America. According to the most recent U.S. census, Latinos now make-up about 15 % of the U.S. population, or about 45,000,000 individuals in the United States. Although migratory influx is one source for this growth, in reality the increase comes from children born on U.S. soil.

A large segment of the Latino population is still living under unfavorable social conditions. In 2007, 32.1 percent of the Hispanic population was not covered by health insurance, as compared to 10.4 percent of the non-Hispanic White population.

The United States Center for Disease Control defines three different types of diabetes.

1. Type 1 diabetes, formerly called insulin-dependent or juvenile-onset diabetes accounts for 5% to 10% of all diagnosed cases of diabetes. Type 1 diabetes develops when the body's immune system destroys pancreatic beta cells, the only cells in the body that make the hormone insulin that regulates blood glucose. It usually occurs in children and young adults, but it can begin at any age. People with type 1 diabetes must have insulin delivered by injection or a pump. Risk factors for type 1 diabetes may be autoimmune, genetic or environmental. There is currently no known way to prevent type 1.

2. Type 2 diabetes, formerly called non–insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes accounts for about 90% to 95% of all diagnosed cases. Type 2 usually begins as insulin resistance, a disorder in which the cells do not use insulin properly and as the need for insulin increases, the pancreas gradually loses its ability to produce it. Type 2 is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians and some other ethnic minorities are at particularly high risk for type 2 diabetes and its complications.

3. Gestational diabetes is a form of glucose intolerance diagnosed during pregnancy. It occurs more frequently among African Americans, Hispanic/Latino Americans and American Indians and is more common among obese women and women with a family history of diabetes. Gestational diabetes requires treatment during pregnancy to normalize maternal blood glucose levels in order to avoid complications in the infant. Only 5% to 10% of women with gestational diabetes are found to have diabetes, usually type 2, and they have a 40% to 60% chance of developing diabetes in the next 5–10 years after pregnancy.

According to the 2004 Behavioral Risk Factor Surveillance System, the epidemic of type 2 diabetes in the U.S. is growing rampant. Some of the states with a high Latino population such as California, Arizona, New Mexico, Texas, Florida and New York have higher diabetes prevalence than other states in the Union. This chart shows the prevalence of self-reported diabetes in several areas with high Latino population as of 2002.

Several national surveys and longitudinal studies have shown that Latinos have a two to four times higher prevalence of diabetes in comparison to other ethnic groups. Mortality for this condition is significantly higher among members of this group than it is others.

Between 2005 and 2050 diabetes cases will increase about 400% among Hispanics, 200% among Blacks and 100% in Whites. Latinos also experience higher mortality and morbidity for diabetes complications like diabetic retinal disease, kidney disease and others.

Diabetes is a leading cause of end-stage renal disease among Latinos. Both Latinos and other minorities have higher rates of diabetic renal disease and this is also the case for other minority ethnic groups.

In this longitudinal observational study of the ethnic differences and ethnic disparities in the incidence of diabetes complications within a non-profit health organization it was clear that age and sex adjusted incident rates of ESRD were significantly higher among Blacks, Asians and Latinos in comparison to non-Hispanic Whites despite uniform health care coverage.

A study performed in 1993 in south Texas comparing Mexican-Americans, African-Americans and non-Hispanic Whites with diabetes showed that Mexican-Americans are more likely to have diabetes-related lower extremity amputations. The study determined the age-adjusted incidence of diabetes-related lower extremity amputations compared with non-Hispanic Whites. In addition, the incidence of lower extremity amputations was significantly higher in non-Hispanic Blacks compared with Mexican-Americans.

Evidence we have from the scientific standpoint shows that there are certain predispositions, certain genetic make-up in general, that makes Hispanic Americans more likely to develop type 2 diabetes over time. But there is no specific gene involved, which is different from type 1 diabetes. It is very clear that there are certain genes that cause certain populations to be at higher risk for type 1 diabetes. This is not the case for type 2. That is why it is important to think in terms of diet, lifestyle and environment.

The San Antonio Heart Study analyzed the effects of diet on specific markers in pre-diabetic people. They looked at something called insulin resistance. This was done on people in San Antonio and a cohort in Mexico City. After some analysis they found that those Mexican-Americans living in San Antonio were at higher risk for diabetes. They had higher rates of insulin resistance compared to those living in Mexico City, for instance. In other words, those living in Mexico City have a healthier lifestyle including diet.

The same cohort from the San Antonio Heart Study compared the prevalence of insulin resistance and hypertension not just with Mexicans living in Mexico City but also with Hispanics living in Spain. Surprisingly, the rates for blood pressure and diabetes were very similar in the cohort in Europe and San Antonio, but San Antonio definitely had the highest rate of diabetes, high blood pressure and lipid abnormalities.