Study Finds Diabetes Among Hispanics Not Equal

People of Hispanic origin living in the U.S. are at high risk for developing type 2 diabetes and related cardiometabolic abnormalities, but the risk varies considerably among specific ethnic groups and according to other factors, including education and length of time living in the U.S.

That is the primary finding of a study led by the University of Miami Miller School of Medicine and published in the August issue of Diabetes Care, based on the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and sponsored by the National Heart, Lung, and Blood Institute. 

Researchers have long known that people of Hispanic background are at higher risk for type 2 diabetes than non-Hispanic Caucasians. However, most research has examined Hispanics as a whole, rather than looking at subgroups, such as Puerto Rican, Mexican and Cuban, and Central and South American.

The results come from the HCHS/SOL, a prospective, multi-center, population-based study conducted in four U.S. metropolitan areas, including Miami-Dade, from 2008-2011. Neil Schneiderman, Ph.D., James L. Knight Professor of Psychology, is the principal investigator of the Miami Field Center and holds dual appointments with  the University of Miami College of Arts & Sciences and the Miller School of Medicine. More than 16,000 people of Hispanic descent enrolled in the HCHS/SOL from Miami, the Bronx, Chicago and San Diego.  

More than 50 million Hispanics currently live in the U.S., making up about 16 percent of the population. The U.S. Census Bureau estimates that by 2050, one in three people living in the U.S. will be of Hispanic origin. To learn more about the health of Hispanics, the National Heart, Lung, and Blood Institute launched the HCHS/SOL. It has found considerable difference among Hispanic groups when it comes to the prevalence of diabetes, as well as low rates of diabetes awareness, disease control, and health insurance.

The study found that the prevalence of total diabetes (both diagnosed and undiagnosed) among all Hispanic groups was roughly 16.9 percent for both men and women, compared with 10.2 percent for non-Hispanic whites. However, when looking separately at ethnic groups that live in the U.S., it found that prevalence varied from a high of 18.3 percent for Mexicans to a low of 10.2 percent for people of South American origin. People of Cuban descent fell in the middle with 13.4 percent having type 2 diabetes, while Dominicans and Puerto Ricans were closer to the high end with 18.1 percent, and 17.7 percent of Central Americans living in the U.S. had type 2 diabetes.

Diabetes prevalence overall was highest for those with low education or household income and increased dramatically with age, reaching more than 50 percent for women by age 70, and 44.3 percent for men aged 70-74. In general, people with diabetes showed low rates of awareness of their condition (41.3 percent), poor control of their glucose level (52 percent) and lacked health insurance (47.9 percent). Interestingly, people 65 and older were more likely to have health insurance and had better control over their glucose levels.

"The picture that emerges from HCHS/SOL is one in which Hispanics/Latinos with diabetes have a high potential future risk of developing complications due to relatively poor glycemic control and diabetes management,” said Schneiderman, who is also Director of the University of Miami Behavioral Medicine Research Center. "Although there is a steep gradient relating high diabetes prevalence to low household income and education in Hispanics/Latinos, the finding of improved diabetes awareness among those who have insurance suggests that increasing the number of those insured may help flatten the gradient.

“If there are any bright highlights in the picture, they are that Hispanics/Latinos older than 65 years, who have better access to healthcare, are more likely to be aware of their diabetes, more likely to be receiving treatment, and have better glycemic control than those people under the age of 65 years."

July 24, 2014