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Highlights from “Diabetes in Latinos/Hispanics: Converting Challenges into Opportunities”
by Enrique Caballero, MD
Endocrinologist/Clinical Investigator
Director, Medical Affairs, Professional Education
Director of the Latino Diabetes Initiative
Joslin Diabetes Center, Harvard Medical School
It’s no secret that prevalence of type 2 diabetes and complications affect Latinos disproportionately.
Dr. Caballero presented the statistics, introduced the theme of cultural competencies and outlined the
Joslin’s contribution through professional development and community outreach.
Statistics about Latinos and Diabetes
There is disparate and disproportionate prevalence of long term complications of type 2 diabetes in
minorities vs. whites.
The prevalence of type 2 diabetes among Latinos is roughly double that of non-Latino Whites.
Moreover, the projected increase in the US Latino population with diagnosed diabetes by 2020 is
expected to be over 100%, versus only 20% increase among non-Latino Whites and 40% among non-
Latino Blacks. Overall, Latinos represent a rapidly growing population.
Given these alarming trends, Dr. Caballero, who heads the Latino Diabetes Initiative at Joslin Diabetes
Center in Boston, shared with us insight the Initiative has gained over the years in providing
education and care for this unique population, including an audio novella for low health literacy
patients, entitled “La Historia de Rosa/Rosa’s Story”, developed by the Initiative to provide culturally
oriented patient self-management education to Hispanics and Latinos.
Part of the challenge, Dr. Caballero explained, is the diversity of races and ethnicities which compose
the “Latino” community. Their race could be white, black and/or American Indian. Their ethnicity could
include any number of countries in South or Central America representing different cultural factors and
orientation toward health and disease management.
Common themes, however, include insulin resistance, abdominal obesity, socio-economic stress, lack
of exercise, defects in incretin function and beta cell dysfunction leading to type 2 diabetes. The same
combination of socio-economic, cultural factors and biological factors continue to cause frequent
chronic complications leading to increase mortality rates.
According to Dr. Caballero, the main factors that may influence diabetes development and care in
culturally diverse populations include the following:
Acculturation
Body Image
Cultural Competence
Depression
Educational Level
Fears
General Family Integration and Support
Health Literacy
Individual and Social Interaction
Judgment about disease
Knowledge about the disease
Language
Myths
Nutritional Preferences
Other forms of Medicine (Alternative)
Physical Activity Preferences
Quality of Life
Religion
Socio-economic status
In one poignant example, Dr. Caballero shared how a prescription for Lisinopril 10 mg. Once/d. was
misinterpreted to mean eleven (11) daily instead of once daily with disastrous results. The patient
was rushed to the ER due to severe hypotension. The Spanish word “once” means eleven, so it was
a very easy mistake to make.
The skills for cultural competence with such a diverse population create challenges for health care
providers. The basis of cross-cultural care is an awareness of the cultural or social factors that are
distinct.
At the Joslin’s Latino Diabetes Initiative, the overall goal is to improve the lives of Latinos affected by
diabetes or at risk for the disease through culturally oriented patient care, education and research.
The mean A1C levels in patients who have regularly attended the Program went down by 1%. The
Latino Diabetes Initiative offers professional education and community outreach.
See http://www.joslin.org/latino for more information.
back to home page
by Enrique Caballero, MD
Endocrinologist/Clinical Investigator
Director, Medical Affairs, Professional Education
Director of the Latino Diabetes Initiative
Joslin Diabetes Center, Harvard Medical School
It’s no secret that prevalence of type 2 diabetes and complications affect Latinos disproportionately.
Dr. Caballero presented the statistics, introduced the theme of cultural competencies and outlined the
Joslin’s contribution through professional development and community outreach.
Statistics about Latinos and Diabetes
There is disparate and disproportionate prevalence of long term complications of type 2 diabetes in
minorities vs. whites.
The prevalence of type 2 diabetes among Latinos is roughly double that of non-Latino Whites.
Moreover, the projected increase in the US Latino population with diagnosed diabetes by 2020 is
expected to be over 100%, versus only 20% increase among non-Latino Whites and 40% among non-
Latino Blacks. Overall, Latinos represent a rapidly growing population.
Given these alarming trends, Dr. Caballero, who heads the Latino Diabetes Initiative at Joslin Diabetes
Center in Boston, shared with us insight the Initiative has gained over the years in providing
education and care for this unique population, including an audio novella for low health literacy
patients, entitled “La Historia de Rosa/Rosa’s Story”, developed by the Initiative to provide culturally
oriented patient self-management education to Hispanics and Latinos.
Part of the challenge, Dr. Caballero explained, is the diversity of races and ethnicities which compose
the “Latino” community. Their race could be white, black and/or American Indian. Their ethnicity could
include any number of countries in South or Central America representing different cultural factors and
orientation toward health and disease management.
Common themes, however, include insulin resistance, abdominal obesity, socio-economic stress, lack
of exercise, defects in incretin function and beta cell dysfunction leading to type 2 diabetes. The same
combination of socio-economic, cultural factors and biological factors continue to cause frequent
chronic complications leading to increase mortality rates.
According to Dr. Caballero, the main factors that may influence diabetes development and care in
culturally diverse populations include the following:
Acculturation
Body Image
Cultural Competence
Depression
Educational Level
Fears
General Family Integration and Support
Health Literacy
Individual and Social Interaction
Judgment about disease
Knowledge about the disease
Language
Myths
Nutritional Preferences
Other forms of Medicine (Alternative)
Physical Activity Preferences
Quality of Life
Religion
Socio-economic status
In one poignant example, Dr. Caballero shared how a prescription for Lisinopril 10 mg. Once/d. was
misinterpreted to mean eleven (11) daily instead of once daily with disastrous results. The patient
was rushed to the ER due to severe hypotension. The Spanish word “once” means eleven, so it was
a very easy mistake to make.
The skills for cultural competence with such a diverse population create challenges for health care
providers. The basis of cross-cultural care is an awareness of the cultural or social factors that are
distinct.
At the Joslin’s Latino Diabetes Initiative, the overall goal is to improve the lives of Latinos affected by
diabetes or at risk for the disease through culturally oriented patient care, education and research.
The mean A1C levels in patients who have regularly attended the Program went down by 1%. The
Latino Diabetes Initiative offers professional education and community outreach.
See http://www.joslin.org/latino for more information.
back to home page
| Fall Statewide Meeting - October 31, 2008 |
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