Diabetes in Hispanic Americans

Most of the information on diabetes in Hispanic Americans comes from four large studies: the San Antonio Heart Study, the San Luis Valley Diabetes Study, the Starr County Study, and the Hispanic Heal th and Nutr i t ion Examinat ion Survey (HHANES). These studies have clearly established that the prevalence of non-insulin-dependent diabetes mellitus (NIDDM) is two to three times higher in Mexican Americans than in non-Hispanic whites. HHANES is the only one of the four studies that included information on Cuban Americans in the Miami area and Puerto Ricans in the New York City area. Diabetes prevalence in Puerto Ricans was as high as in Mexican Americans. Cuban Americans had a lower prevalence, although it was still 30%50% higher than in non-Hispanic whites. Risk factors for NIDDM in Hispanic Americans are similar to those in non-Hispanics and include obesity, unfavorable distribution of body fat, hyperinsulinemia, and dyslipidemia (high triglyceride and low highdensity lipoprotein, HDL). These abnormalities are also more common in nondiabetic Mexican Americans. NIDDM prevalence in Mexican Americans in Texas tends to be inversely related to socioeconomic status and degree of acculturation to mainstream U.S. society. Little is known about behavioral factors that may mediate these sociocultural effects, although newly diagnosed diabetic Hispanics in Colorado reported consuming greater amounts of dietary fat than nondiabetic Hispanics. There is a strong ecological association between the percentage of Native American genetic admixture and the prevalence of diabetes in various Hispanic and Native American populations. Since admixture and sociocultural factors co-vary, it is difficult to disentangle their joint effects on diabetes risk.