Building cultural competency for improved diabetes care: Latino Americans and diabetes.

The incidence of type 2 diabetes (T2DM) has reached epidemic proportions in the Latino American community, contributing to substantial morbidity, mortality, and health care costs. In fact, 2.5 million Latino Americans are affected by T2DM. Compared with the general population, Latino Americans suffer a higher burden of disease: 14% of Latino Americans have T2DM compared with 12% of African Americans and 7% of non-Hispanic whites. Further, using glycosylated hemoglobin (A1C) as a marker indicates that Latino Americans have poorer disease control; higher rates of complications, including diabetic retinopathy, nephropathy, and amputations; and increased mortality. According to a recent survey, Mexican Americans are less likely to achieve glycemic control than are non-Hispanic whites. Peripheral vascular disease is 80% more common among Mexican Americans than among whites with diabetes, and mortality rates due to diabetes are twice as high among Mexican Americans and Puerto Ricans as among non-Hispanic whites. Despite greater understanding of the etiology of T2DM and the development of novel treatment strategies, T2DM is on the rise among Latino American populations. While the prevalence of T2DM is projected to increase in the general population by 44% by 2020, it is projected to increase by 107% in the Latino American population. Latino American children born today have a 50% chance of developing T2DM in their lifetime. These startling statistics underscore the need for the health care community to focus on the prevention and treatment of T2DM among Latino Americans, and, indeed, research has shown that effective communication directly affects physician-patient interaction and subsequent outcomes.