Tag Archives: Diabetes

How Social Factors Affect Diabetes Prevalence Among U.S. Hispanic Subgroups

Early this month, Global Health Aging published an article about the dangers of type 2 diabetes among older Hispanics. The focus will now be on the prevalence of this disease among Hispanics including the impact of age, food habits, urbanization and length of stay in the U.S.

Photo Credit: lucianvenutian
                                                    Photo Credit: lucianvenutian

People of Latino and Hispanic descent are at a high risk of type 2 diabetes and related conditions. In the August 2014 issue of Diabetes Care, a study found that the risk varies a great deal among specific subgroups and even based on other factors like how long they have lived in the United States.

According to the study, the prevalence of diabetes (diagnosed and undiagnosed) among Hispanics and Latinos of all groups was 16.9 percent for men and women compared to 10.2 percent for non-Hispanic whites. Prevalence varied a great deal when looking at subgroups. For example, individuals of Mexican descent had the highest prevalence at 18.3 percent while those of South American descent had the lowest prevalence of 10.2 percent. People of Puerto Rican and Dominican descent had a diabetes prevalence of 18.1 percent and those of Central American descent had a rate of 17.7 percent. More than 13 percent of people with Cuban descent had diabetes. This shows a strong correlation between diabetes and people of Hispanic descent in the United States. Many factors are responsible for the diabetes prevalence including unhealthy eating habits.

In the United States, Houston makes a great case study because of the city’s makeup and close location to Mexico and the Deep South. David Napier of University College London (UCL) states that “People used food as not only a reinforcement of tradition and ritual but also as a way of connecting socially. You’ve moved here from somewhere else, it’s a way to reinforce your identity, it’s a real cultural asset to have, but in a biological sense it’s not the best thing.” Nutrition is complex when tackling diabetes or obesity in Hispanic subgroups. This is why a flexible and targeted approach about healthy eating is necessary for fighting these conditions. Ultimately, the goal is not to get rid of traditional foods, but to find ways to make those foods healthier or introduce better options.

Other factors contributing to the diabetes prevalence include age, urbanization and length of stay in the U.S. The study published by Diabetes Care stated that diabetes rates increased significantly with age to 50 percent among Hispanic and Latino women by the age of 70 and 44 percent for men between ages 70 and 74. The study also reported that the longer someone lived in the U.S., the more likely they were to develop type 2 diabetes. Moreover, urban areas of Venezuela, Chile and Argentina are experiencing rising diabetes rates partly to traffic, crowded living conditions, air pollution, and a more sedentary lifestyle, according to a report by the Center for Strategic and International Studies.

Type 2 diabetes is a serious global concern. Society needs to tackle the disease on all fronts because the consequences can be fatal. It is important to raise awareness of the complications and hope that medical professionals find new ways to reduce the burden of diabetes.

Sophie Okolo is the Founder and Editor-in-Chief of Global Health Aging.

Parul Patel, DPM is the lead physician of Infinity Foot and Ankle, a podiatry practice with three locations in Texas. She has more than 11 years of experience in podiatric medicine. Dr. Patel specializes in podiatric care such as diabetic podiatry, preventative care and surgical podiatry.


The Dangers of Type 2 Diabetes among Older Hispanics

Photo Credit: Pixabay
Photo Credit: Pixabay

Diabetes is a 5th leading cause of death among Hispanics and Latinos in the USA. Hispanics are 66 percent more likely to be diagnosed with diabetes compared to non-Hispanic whites and they have a 1.4 times greater risk of developing chronic kidney disease due to diabetes, according to the National Kidney Foundation. Moreover, there is currently an epidemic of diabetes among Hispanics and Latinos not only in the United States but also in Central America.

The Dangers of Type 2 Diabetes

Type 2 diabetes carries a number of dangers. While it may be easy to ignore, the disease affects the blood vessels, nerves, heart, kidneys and eyes. Complications of diabetes can eventually become life-threatening or disabling regardless of race. In fact, several studies have found that Hispanics and Latinos are at a greater risk of two of the most serious risks of diabetes: end-stage renal disease and foot amputation. Most cases of end-stage renal disease (ESRD) are caused by diabetes and these cases are on the rise throughout Central and South America, according to a study published in the Clinical Kidney Journal. The study reported that the highest incidence of diabetes-caused ESRD was found in Mexico and Colombia.

Research has found that Hispanics and Latinos are also at a higher risk of foot damage due to diabetes than non-Hispanic whites. Diabetes can lead to nerve damage in the feet and poor blood flow which raises the risk of a host of foot complications. In severe cases, toe, foot, or even leg amputation may be necessary. Diabetes is the leading cause of foot and leg amputations in the United States and Mexico. Between 2001 and 2004, the hospitalization rate for diabetes-related amputation among Hispanics and Latinos increased to 80 per 100,000 compared to roughly 28-31 per 100,000 for non-Hispanic whites.

Diabetics in developing countries are twice as likely to develop foot ulcers and require amputation than those in developed countries. In South and Central America, about 1.25 million diabetics undergo foot amputation. This number is expected to rise to 2.5 million by 2030, according to the International Diabetes Federation.

A great deal of the disparity is attributed to lack of health care and screening. Just 38 percent of adult Hispanics over the age of 40 with diabetes received the recommended annual foot, eye and blood sugar screenings compared to 47 percent for whites and blacks in the U.S. Hispanics were also 3.6 times more likely than non-Hispanic whites to be hospitalized for uncontrolled diabetes and 2.9 times more likely to be hospitalized for foot or leg amputation due to diabetes.

Controlling Type 2 Diabetes

Diabetes can develop at any age but it is most often diagnosed in middle-aged and older people. Screening for type 2 diabetes is especially important after the age of 40. Therefore, it is important to note that while diabetes complications can be very serious, they are avoidable. The best way to avoid serious foot problems, including gangrene and amputation, is by receiving regular diabetic foot care and maintaining a healthy blood sugar level. Seeking the care of a knowledgeable foot and ankle doctor should also be top priority for all diabetic patients to avoid potentially life-threatening complications that may seem benign at first.

Parul Patel, DPM is the lead physician of Infinity Foot and Ankle, a podiatry practice with three locations in Texas. She has more than 11 years of experience in podiatric medicine and specializes in podiatric care such as diabetic podiatry, preventative care and surgical podiatry.

India is Diabetes Capital of the World

Photo Credit: Pixabay
Photo Credit: Pixabay

P Pushpam, a resident of Chennai, India, was denied her job appointment with the Indian Railways on the grounds that she was a chronic diabetic. The court ruled in her favor and pointed out the impracticality of discriminating against people suffering from diabetes in a country that has over 40 million diabetics.

As India makes its demographic transition toward lower birth rates and higher life expectancy, the prevalence of non-communicable diseases is on the rise. India is the “Diabetes Capital of the World” with over 60 million diabetics in the country, that is projected to at least double by 2030. The country ranks second, between China with 90 million and USA with 24 million diabetics. About 17% of the country has diabetes and about 77 million are considered to be pre-diabetic, which refers to those individuals who have higher than normal blood glucose levels, but not high enough to categorize them as diabetic.

Disability-adjusted life years (DALYs) is a measure of the burden of a specific disease in a population. A study shows that the DALYs attributed to communicable diseases in India such as malaria and TB will decrease. However, the DALYs associated with diabetes and other non-communicable diseases will increase. When compared to China, another country with a large and rapidly aging population, one sees a decrease in the DALYs for both communicable and non-communicable diseases.

Smoking, poor physical activity and alcohol use are some pertinent risk factors of diabetes in India. A survey revealed that close to 40% of Indian men are daily smokers and approximately 18% of the study respondents had poor physical activity levels. The survey also suggested that in addition to these individual level risk factors, environmental factors, specifically indoor air pollution contributes to the increasing prevalence of diabetes. The incidence of solid fuel use, contributing to air pollution in India is 83.5%. An urban lifestyle, and increasing strength of the food, fertilizer, pharmaceutical and beverage industries in the past decades, also contributes to a higher prevalence of diabetes.

A major obstacle to diabetes in elderly health is the lack of awareness of one’s status. A study in the urban slum of New Delhi reported that only 36% of their respondents were aware of their diabetic status. Low awareness among the elderly is linked with difficulties in screening, diagnosis and treatment abilities. Elderly patients tend to have lower mobility and are more likely to be dependent on their family members, delaying their ability to seek care.

The increasing prevalence of diabetes management among the elderly places a huge burden on the Indian health care system. While lifestyle modification is the most cost-effective solution to this growing epidemic, a more intense plan of management and care for elderly diabetics is needed.

Namratha Rao is currently pursuing her MSPH in International Health in Social and Behavioral Interventions at the Johns Hopkins University Bloomberg School of Public Health.