Latinos may be at increased risk for developing diabetes because of language and socio-economic barriers. In addition, poor access to healthcare and adaptation to the Western diet may also be risk factors. According to WHO (World Health Organization), 80% of people with diabetes live in low and middle-income countries, and the prevalence of diabetes decreases with higher education. The CDC reports that among Latinos with less than a high school education, 11.8% had diabetes, compared to 7% of college graduates. This may be because Latinos with more education would likely have a better support network and a higher income. It is another reason to encourage children to “stay in school.” 

Early testing is required to determine those who are at higher risk. By identifying these high risk groups, we are able to initiate an aggressive prevention strategy. These groups are identified as the following: over age 45; first degree relative with diabetes; Latinos, African Americans, Native Americans; history of gestational diabetes; increased weight; and conditions associated with metabolic syndrome. Fasting plasma glucose of 126 mg/dl is one of the measures that is utilized to diagnose diabetes. Type 2 diabetes, or noninsulin dependent diabetes, is the most common form and is a result of the body not producing enough insulin or not properly utilizing it. 

As it is preferable to prevent diabetes than to treat it after it is present, it is important to start education early. Classic symptoms of diabetes include excessive thirst, frequent urination and constant hunger. Obesity is thought to be the primary cause in those who are genetically predisposed to diabetes, according to the American Diabetes Association (ADA). A high waist circumference (40 inches for men and 35 inches for women) and blood pressure greater than 135/80 are risk factors for diabetes. Lack of exercise, a diet high in carbohydrates, excess sodium, smoking and alcohol abuse are all factors that can be modified with encouragement and support by clinicians and health educators. 

Cultural awareness among health care workers needs to be raised to address this epidemic. As a clinician, I stress the importance of a healthy diet in order to reduce the risk of diabetes. However, the typical western diet and the new eating guidelines from the federal government depicted in “My Plate” are not ideal for Latinos. Clinicians can utilize a program offered by the ADA to help Latinos eat healthier. The program, entitled “Por Tu Familia,” or “For Your Family,” focuses on Latinos who may have diabetes, those who are at increased risk or those that just want to learn more about this disease. Outreach efforts include workshops geared toward helping Latinos eat better. One of the workshops is entitled “Cooking with Latino Flare,” encouraging Latinos to cook healthier using typical Latino foods.

The risk of developing diabetes can be cut in half by proper nutrition and regular exercise. However, many Latino women do not enjoy the typical gym workout as much as dancing. Most of them will get the majority of their exercise by doing recreational dance. Another workshop that is offered is “Dancing for your Health.” Latinos like to dance and express themselves through movement. Moreover, these workshops are typically led by other Latinos which also helps to drive the message home to the community about the importance of health. These community-based programs along with cultural awareness by clinicians can help prevent the spread of this disease.

Finally, educating my patients about their risk factors is two¬fold: I not only educate them, but I also educate their children and everyone in their family. In the Latino culture, many family members are involved in the medical care of others. They often come to the doctor’s office together which helps to convey the message of a healthier lifestyle to everyone in the household. I encourage patients to bring their family members to visits for this purpose and to identify others who may be at risk. In addition, as a bilingual physician, I have the advantage of speaking with my patients in their native language and being able to educate them about the consequences of this illness. Our health centers also offer patients a visit with a health educator who takes the time to inform them of their risks and works with them to develop lifestyle and dietary changes that will improve their overall health. Understanding the cultural differences among Latinos will help guide the preventive strategies for eliminating diabetes.

“¡Si se puede!” Together, “We can do it!”

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