Special considerations on the management of Latino patients with type 2 diabetes mellitus

Latinos are the largest minority population in the United States, and are characterized by higher rates of obesity and diabetes compared to Whites. The prevalence of diagnosed diabetes in Latinos is two-fold higher than in Caucasians, and Latinos suffer from higher rates of diabetic complications and mortality. As the diabetes epidemic continues to expand and exert greater socioeconomic strain on national healthcare systems, the success of global and national healthcare initiatives for diabetes prevention and improvement of care will depend upon strategies targeted specifically toward this population. Essential to such strategies is an understanding of success factors unique to the Latino population for diabetes prevention and achievement of optimal treatment outcomes. A PubMed search was conducted for literature describing type 2 diabetes and its complications in Latinos. Specifically, we sought data describing epidemiology, disparities, management considerations, and success factors in this population. The title search yielded more than 2000 articles, 80 of which were deemed directly relevant to this review. The inherent limitations of this subjective selection process are acknowledged. A number of studies have highlighted various ethnic disparities in Latinos with diabetes including higher HbA1c levels, greater rates of obesity and metabolic syndrome, and a larger proportion of individuals with inadequate access to care. While relatively fewer studies describe success factors for redressing cultural disparities in diabetes, the current body of literature supports primary care strategies aimed at effective provider--patient relationships and culturally tailored education and lifestyle modification regimens. Further research demonstrating effective, culturally tailored practices that are suitable to the primary care setting would be of value to providers treating Latinos with diabetes.