Type 2 Diabetes Mellitus in Latinx Populations in the United States: A Culturally Relevant Literature Review

Abstract

Type 2 diabetes mellitus (T2DM) affects a large number of the American population. When compared to their representation in the general American population, a disproportionate number of Latinx individuals are affected. Within the Latinx American population, T2DM prevalence rates vary among individuals based on their country of origin. Deaths from T2DM among Latinx American population are also more compared to other ethnicities. This disparity underlines the importance of understanding the cultural considerations of T2DM disease presentation and management in Latinx communities, including risk factors, socioeconomic variables, and other social determinants of health such as access to care. There are various modifiable and non-modifiable risk factors for the development of T2DM, regardless of race. Staple foods in the diet of Latinx American communities, such as tortillas, rice, and beans, can cause spikes in blood sugar levels and can lead to obesity, which predisposes patients to develop T2DM. Latinx American populations suffer from lower access to healthcare than the general population due to many reasons, including language proficiency, immigration status, socioeconomic status, and level of acculturation. This study utilized the format of a commentary, while incorporating elements of a scoping review for data collection, to further explore these disparities and their impact on these populations. Understanding the cultural beliefs of Latinx individuals and how these beliefs contribute to the perceived development of T2DM is essential to properly treat these unique populations. Despite high rates of T2DM affecting Latinx individuals, non-adherence to prescribed diabetes medications is high among these populations. Interventions in the form of culturally tailored preventative education, in addition to active T2DM management, are necessary to combat the toll of this disease on Latinx Americans. Generic interventional techniques and methods should be replaced entirely by those that acknowledge, highlight, and utilize the sociocultural characteristics of Latinx Americans.

The ACTIVATE Digital Health Pilot Program for Diabetes and Hypertension in an Underserved and Rural Community

“…35,36 Hispanic and Latinx populations in the United States have a documented higher prevalence of diabetes and worse glycemic control outcomes 37,38 and higher death rates. 39 Hypertension studies have documented rural Hispanic and Latinx individuals were more likely to have persistent undiagnosed, untreated, and uncontrolled hypertension. 40,41 California's Central Valley, a rural and agricultural region, houses a predominantly Hispanic and Latinx population facing the state's worst environmental conditions, extreme poverty, and health professional shortages.…”

Glycemic and Cost Outcomes among Hispanic/Latino People with Type 2 Diabetes in the USA Initiating Dulaglutide versus Basal Insulin: a Real-World Study

“…Barriers to optimal glycemic management in Hispanic/Latino people with T2D are often rooted in inequitable access to healthcare resources, including lack of health insurance, financial and language barriers, and poor health literacy [ 7 ]. This results in adverse health outcomes, greater disease severity, and a substantial comorbidity burden on individuals and the healthcare system [ 4 , 6 , 8 , 9 ]. According to the American Diabetes Association (ADA), care for people with diabetes, including direct medical costs and reduced productivity, amounted to $327 billion in 2017 [ 10 ].…”

COVID-19 stressors for Hispanic/Latino patients living with type 2 diabetes: a qualitative study

“…Other factors, such as a lack of patient-provider concordance, cultural values and beliefs (e.g. fatalism), and attitudes toward diabetes and treatments, are documented influences on the adherence to and outcomes of diabetes management in H/L individuals (17)(18)(19)(20).…”

“…Overall, people with T2D reported eating more, exercising less, and having higher levels of stress and depression than in the pre-pandemic period (22,23). For H/L populations with strong family ties (19,20), lockdowns and shelter-in-place orders meant less access to social support networks, which could have exacerbated mental health effects (22). Depression and diabetes distress are two conditions that are known to affect people with T2D, which can also directly increase the risk of mortality, work absenteeism, and poor diabetes management and health outcomes (24,25).…”