Hispanic diabetes rate up
November 8, 2004
By Deborah Allnard
WESTPORT -- Hispanic-Americans, specifically from Puerto Rico, are not only becoming the largest minority group in southeastern Massachusetts -- they are also developing diabetes at a higher rate than Caucasians, African-Americans and other Latino groups.
This growing phenomenon was outlined recently at the Diabetes Association’s annual symposium at White’s of Westport to mark Diabetes Awareness Month.
"We’re not doing a good job of controlling diabetes. Period," said Dr. Enrique Caballero, a clinical investigator, staff endocrinologist and assistant director of continuing medical education at the Joslin Diabetes Center in Boston. "And, of course, people are developing complications (from the disease) all the time."
Currently, 18.2 million people have diabetes in the United States, which accounts for 6.5 to 7 percent of the total population, according to Caballero.
While Caucasians suffer diabetes at about the same rate as the national average, some minority groups are tipping the scales. Ten to 12 percent of the Latino and black populations in the country have diabetes, according to Caballero.
In Massachusetts, the Hispanic population has grown to 428,729, surpassing the African-American population of 343,454, according to the 2000 census.
Researchers have been trying to discover just why Latinos --comprising people from Mexico, Cuba and Puerto Rico -- have such a high rate of the disease.
Caballero, who is directing a clinical and research effort for the Joslin Latino Diabetes Initiative, said genetics and lifestyle factors are driving up the numbers.
For many people, genes do play a role in developing diabetes. For Latinos, especially those from Puerto Rico, it may be the particular gene mix -- Caucasian, black and Native Indian genes combined, he said.
Since African-Americans have a high rate of developing diabetes, Latinos with more black heritage do, as well.
The "thrifty gene hypothesis," according to Caballero, explains that many years ago, when people didn’t have much food to eat, their bodies may have adapted to survive by being able to raise blood sugar levels with very little food.
Today, with no food shortage in America, what once protected those groups may now be hurting them.
Regardless of gene findings and hypotheses, Caballero said, there are more modern factors in the high rate of diabetes in Latinos and the general population.
"We all know obesity is clearly linked to diabetes," said Caballero.
Type II diabetes, which is also known as adult onset diabetes, occurs 10 times more frequently than does Type I diabetes. There are also more incidences of Type II diabetes appearing in children, "something we didn’t see before."
"The rates of diabetes are increasing. The rates of obesity are increasing," Caballero said.
Abdominal fat has also been linked to diabetes. Caballero said women with a waist of 35 inches or larger, and men with a 40 inch waist or larger, have a higher occurrence of developing diabetes.
That extra fat, said Caballero, is active in producing certain hormones that affect how insulin works in different tissues in the body, such as the pancreas, which produces insulin.
A three-year study found that those who lost even 5 percent of their body weight and exercised for 30 minutes a day, five days a week, decreased their risk of developing diabetes by 58 percent. Medication decreased diabetic onset by just 31 percent.
Caballero said: "Every time we gain weight, we double and triple (the rate of) diabetes."
"Even if you don’t prevent it forever, if you can delay the progress of the disease you can delay the complications," said Caballero.
He said preventing complications, such as cardiovascular disease, blindness, stroke and amputations, will save lives.
"Cardiovascular disease is the Number 1 killer of those with diabetes," said Caballero.
He said people with diabetes also have a higher risk of having a heart attack than those without diabetes who have already suffered a first heart attack.
"We need to act earlier to prevent diabetes," said Caballero. "We need to identify people with pre-diabetes."
Source:www.heraldnews.com
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