Addressing The Prediabetes Crisis: A Spotlight On The Hispanic/Latino Population's Vulnerability

Diabetes is a complicated disease and can be caused by several risk factors, including genetics. There are two different types of diabetes, known as type 1 and type 2. We’ll be discussing type 2 diabetes, which is much more commonly acquired in adulthood.¹

The connection between prediabetes and type 2 diabetes in the Hispanic and Latino population

Prediabetes is different from type 2 diabetes. As the name suggests, prediabetes is an earlier stage of blood sugar control loss. People with prediabetes are at a higher risk for developing diabetes, although it isn’t inevitable. Some people with prediabetes never go on to develop type 2 diabetes, and it’s even possible to return to having normal blood sugar control.²

Prediabetes is much more common in some portions of the population than others. For example, Hispanic or Latino people are much more likely to develop type 2 diabetes, with 17% having the condition. This is significantly higher than the rate in the non-Hispanic White population (8%).³

The terms Hispanic and Latino also encompass a wide range of people, including those from Puerto Rico, Cuba, Mexico, and Central and South America. The prevalence of type 2 diabetes and prediabetes within these populations are also different. For example, South American people have about half the risk Puerto Rican people have. It’s believed that genetic differences play a significant role in determining people’s risk of type 2 diabetes.

In the US, Hispanic adults have rates of diabetes that are 80% higher than those of non-Hispanic Whites, and Hispanic children are around five times more likely to experience diabetes than their non-Hispanic White counterparts.⁴

For Hispanic and Latino populations, prediabetes is even more common than diabetes, with around 36% of people in one US study meeting the criteria for prediabetes.⁵ Therefore, it’s critical that early interventions for diabetes be made available to this group. By learning about their condition and the risk of progression, people become empowered to take actions that will reduce their future risk. 

Hispanic and Latino people with diabetes are also more likely than Whites to experience serious complications from diabetes, such as kidney disease.⁶ This may be because Hispanic and Latino people are more likely to face issues like difficulty accessing medical care. 

Also, there’s often a language barrier preventing them from accessing reliable health information. They may not be able to easily access screening tests, which would identify a problem in its early stages and allow for intervention before it progresses. The same issues may contribute to a higher risk of diabetes-related retinopathy (eye disease) in this population.⁷

Altogether, several factors may contribute to the higher prevalence of diabetes and prediabetes in the Hispanic and Latino populations. These include a lack of equitable access to medical care and a genetic prevalence of the disease. 

Understanding manageable risk factors for prediabetes in Hispanic communities

In addition to understanding how complex diabetes and prediabetes can be for Hispanic and Latino populations, it’s also important to know how to manage prediabetes and prevent it from progressing to type 2 diabetes.

Hispanic and Latino populations may have different beliefs from non-Hispanic White populations regarding what causes diabetes. One study in the US showed that Hispanic populations were more likely to believe that diabetes can be caused by experiencing major emotional stress.⁸

In fact, this is not true — stress does not directly lead to the development of diabetes. When the cause of diabetes is perceived differently in Hispanic populations, it could lead to patients not realizing the steps they need to take to reduce their risk, which could lead to the development of the disease.

Instead of stress, the most common causes of diabetes are unhealthy diets, lack of exercise, and heredity. While you can’t change genetics, you can modify your diet and how much you exercise. 

Interestingly, studies have found that Latino immigrants to the US engage in healthier behaviors than non-Hispanic Whites in the US do.⁹ For example, people born in Mexico are much more likely to take in guideline-recommended amounts of fats, fibers, potassium, and vitamins compared to their counterparts born in the US.

However, this tends to change over time as the immigrants become immersed in the US culture. The most significant change is that people tend to adopt a poorer diet as acculturation progresses. This may increase the risk of developing prediabetes and the risk of it progressing to full-blown diabetes.

Changing your diet is one of the best early interventions to deal with prediabetes. For many people, diet management can help to reduce blood sugar to healthy levels, which can help prevent the progression of the disease into type 2 diabetes. 

However, for those living in the US, diet management may not be all that simple, especially for those on lower incomes. For instance, people in some lower-income areas find it harder to get unprocessed foods or foods with low levels of added sugars. When they’re available, healthier foods also generally cost more than highly processed cheap foods, so many people can’t afford to eat them regularly. 

It’s important to emphasize that the extra cost of a healthy diet is much lower than the cost of diabetes treatments, such as insulin, for the rest of a person’s life. Although many low-income people struggle to afford healthy food, it will be cheaper in the long run than diabetes treatment. It will also lead to improvements in quality of life and longevity.

In addition to diet, getting the recommended 15 hours weekly of moderate exercise (like brisk walking) can have a major impact on reducing the risk of type 2 diabetes. Exercise can help reduce overall weight and waist size and improve the body’s sensitivity to insulin.¹⁰

One other important risk factor is smoking. Smoking increases the risk of developing type 2 diabetes, so it’s important to stop smoking, especially if you’re already at risk.¹¹

Uncontrollable and genetic risk factors for type 2 diabetes

Unfortunately, some risk factors for type 2 diabetes aren’t within your control. Those with additional risk factors they can’t change should be particularly diligent about modifying the risk factors they can control, like diet and exercise.

Unmodifiable risk factors include race (as explained above) and other factors that may or may not be linked to race, including your family history. If a member of your immediate family has type 2 diabetes, you’ll be more likely to develop it yourself. This very likely shows that there’s a genetic component to diabetes, and Hispanic and Latino populations in the US may have a genetic predisposition to develop diabetes.¹²

Other uncontrollable risk factors include age. Being over the age of 45 is a risk factor.¹³ In addition, having gestational diabetes, or diabetes that develops during pregnancy, also increases a woman’s risk of later developing type 2 diabetes. This is more common in Hispanic or Latino populations than in the general US population.¹⁴

The importance of early screening for prediabetes

It’s very important to screen early for prediabetes, particularly if you have risk factors for the disease. The earlier you are diagnosed with prediabetes, the easier it is to treat, and the more likely you are to get your blood sugar back down to healthy levels. 

Three tests are currently recommended for diagnosing prediabetes: hemoglobin A1c (HbA1C), fasting glucose, and the oral glucose tolerance test (OGTT).¹⁵ These are all blood tests. HbA1c checks your average blood sugar level over time. Fasting glucose looks at your blood sugar level when you haven’t eaten for a period of time. The OGTT checks how your blood sugar responds to consuming a specific amount of sugar in the form of a drink. 

You don’t need to have all three of these tests. Any one of them can potentially be used for screening, and the one recommended depends on your specific situation. 

For instance, the HbA1c test doesn’t require a long fasting period or hanging around the lab for a few hours, making it the most convenient option. It’s also less affected by stress and illness than other forms of testing. However, this test may miss some cases of prediabetes that other tests would catch.¹⁶ If you’re at particularly high risk, another test may be better to ensure that prediabetes isn’t missed.

It’s usually best for your healthcare provider to decide on the type of test and interpret your results. 

What can you do to prevent prediabetes?

Prevention of prediabetes can be difficult to manage alone. It’s often helpful to have support. You may want to sign up for a lifestyle change program.¹⁷

The lifestyle change program helps you build healthier habits, such as more frequent exercise and healthier eating. You’ll be assigned a coach who will adapt the program to your specific needs. Your coach will be aware of any cultural differences that may impact your participation in the program, allowing them to personalize it for you. 

A lifestyle change program can be useful for people struggling to manage prediabetes with the information they get from a healthcare provider or the internet alone. 

If you can’t attend such a program just yet, then here are some other simple tips:

• Talk to your healthcare provider about your risk factors for diabetes. This can be hard, especially with sensitive topics such as weight loss, but it can be very beneficial. They’ll be able to explain if you need regular testing or if any other medical interventions could help you reduce your risk.

• Take brisk walks. Although walking is considered a low-impact exercise, it significantly impacts prediabetes. Hispanic or Latino people who walk the recommended 10,000 steps per day are up to 26% less likely to develop diabetes than those who walk only 3,400 steps.¹⁸

• Take steps to improve your diet. We know that diet plays a major role in type 2 diabetes. Try to reduce your excess sugar intake and eat plenty of whole grains and fiber. 

• Stop smoking. If you struggle to quit, ask your doctor for a smoking cessation plan. Quitting smoking is challenging, but it is possible with the right support. 

• Make sure you complete all recommended screening tests. Despite all these interventions, some people are simply at higher risk than others. Routine testing is necessary to give you the best chance of avoiding type 2 diabetes. 

The lowdown

Type 2 diabetes and prediabetes are much more common in Hispanic or Latino adults than in their non-Hispanic White counterparts. This is partially because of uncontrollable risk factors related to genetics, as well as factors associated with socioeconomic status and systemic racism (such as poverty and an inability to access high-quality healthcare). 

The best choice is to have regular screenings and make lifestyle changes to support your health and reduce your risk of prediabetes. If you ignore this issue, you may find yourself with diabetes later in life. If you’re Hispanic or Latino, you could even be at a higher risk for complications from diabetes, like kidney disease and eye disease. Taking action early gives you a chance to avoid major problems later on. 

Frequently asked questions

What are the long-term health risks associated with prediabetes in Hispanic and Latino individuals?

The most obvious risk is the development of type 2 diabetes. However, significant damage to heart, lung, eye, and kidney tissue can also occur before prediabetes even develops into full-blown diabetes. It’s important to take prediabetes seriously.

Are any community-based programs or initiatives targeting prediabetes prevention available for Hispanic and Latino communities?

Yes, although what’s available will depend on many factors, including your geographic area and your ability to travel and access care. Ask your healthcare provider to direct you to specific resources that are available to you.