Difference in Diabetes Incidence Between Hispanic Individuals in the US vs Developed Mexico
Hispanic individuals in the United States have significantly higher diabetes incidence rates compared to those living in developed areas of Mexico, with US Hispanic populations showing approximately 2 times higher incidence of type 2 diabetes than their counterparts in Mexico City. 1
Epidemiological Comparison
United States Hispanic Population
- Hispanic/LatinX populations have the highest age-adjusted total diabetes prevalence among all racial/ethnic groups in the US 2
- The age-adjusted adult incidence rates of diagnosed diabetes for Hispanic/LatinX populations is 9.7 per 1,000, which is higher than other racial/ethnic groups in the US 2
- Mexican Americans specifically have a diabetes prevalence of 14.4%, which is significantly higher than the national average 2
- The prevalence of diagnosed diabetes in US Hispanics is 1.9 times higher than in Caucasians 3
Mexico (Developed Areas)
- A direct comparison study between low-income Mexican-Americans in San Antonio, Texas and low-income residents in Mexico City found that the age- and sex-adjusted incidence of type 2 diabetes was significantly higher in San Antonio (relative risk 2.01) 1
- This difference was most pronounced in the 55-64 year age group 1
- The difference remained statistically significant even after adjusting for numerous diabetes risk factors, including demographic, anthropometric, and metabolic variables 1
Factors Contributing to Higher US Incidence
Acculturation Effects
- Duration of stay in the United States is positively associated with diabetes prevalence among Hispanic/LatinX populations 2
- Individuals with low acculturation (measured by language) were actually more likely to have diabetes (odds ratio 1.90) 4
- Acculturation in the US is associated with:
- Higher calorie processed food intake
- Psychosocial stress-mediated metabolic derangements
- Increased sweet consumption 2
Socioeconomic Factors
- In Hispanic/LatinX populations, diabetes prevalence is negatively associated with education and household income 2
- Hispanics with low acculturation were more likely to be without routine healthcare, have no health insurance, and have low levels of education 4
- Lower income and decreased access to education and healthcare contribute to the higher prevalence of diabetes among US Hispanics 5
Biological Factors
- Genetic susceptibility to obesity and higher insulin resistance may play a role in the increased risk of T2D in Hispanic populations 5
- Hispanic individuals develop T2D at a lower BMI compared with non-Hispanic whites 2
Clinical Implications
Disease Presentation and Complications
- Diabetes is diagnosed at an earlier age in US Hispanics compared to non-Hispanic whites 3
- Among individuals with diagnosed diabetes, those with low language acculturation were more likely to have diabetes complications such as peripheral neuropathy (odds ratio 4.01) 4
- US Hispanics suffer from higher rates of diabetic complications and mortality compared to non-Hispanic whites 3
Screening and Prevention
- The significant difference in diabetes incidence suggests the need for targeted screening and prevention efforts for Hispanic individuals living in the US
- Diabetes self-management education (DSME) programs should take into consideration cultural factors that influence the development and progression of diabetes 5
- Specific interventions directed to Hispanic populations are needed to prevent and alleviate the burden of T2D 5
Key Considerations for Healthcare Providers
- Be aware that Hispanic patients in the US have approximately double the diabetes risk compared to similar populations in Mexico
- Consider earlier and more aggressive screening for Hispanic patients in the US, particularly those who have lived in the US for longer periods
- Address modifiable risk factors that may be influenced by US lifestyle and environment
- Recognize that the disparity increases with age, with the greatest difference seen in older adults (55-64 years)