Filipic Case Study

Type 2 Diabetes in children and adolescents is an emerging epidemic within the last 20

Hispanics households with low socioeconomic status and low education coupled with low diabetes awareness have high type 2 diabetes prevalence 9. The high prevalence rates of type 2 diabetes can be attributed to a number of reasons such as; the Latinos have a genetic tendency to develop insulin resistance and they face high risks for abdominal obesity. The study emphasized that the strongest predictors of developing type 2 diabetes in Hispanic population are impaired insulin sensitivity, low insulin secretion and and glucose effectiveness 1. In addition, the prevalence rates are high in poor families who have poor nutrition and lifestyle behaviors. Since poor families have low access to education, they tend to have low awareness for diabetes hence these results in high diabetes prevalent rates. The results of the study indicated that incidence of diabetes decreased with rising educational level in Hispanic population

With over 30 million people having diabetes, the prevalence is continuing to rise. An estimated 200,000 American youth are effected by type 1 diabetes and 40,000 new cases are diagnosed each year¹. The rate for type 1 diabetes in youth has increased by 1.8% each year. In comparison, the prevalence for type 2 diabetes in youth has increased at a rate of 4.8% annually². No matter whether diabetes is type 1 or type 2 in children, family involvement is essential for optimal outcomes³.

outcome of obesity in this community, there needs to be a sufficient understand of Hispanic

The study had an overall total of 1150 participants. Although there were many participants to begin with, they did not provide all of the feedback the researchers had requested.  This resulted in the expulsion of their participation, so their results were not included in the final reports of the study. The number of patients that did provide the essential information added up to a total of 901. The profile for a participant was a patients diagnosed with Type 2 diabetes in the last 6 months, but has been diagnosed no more than 10 years ago. They had to be between 35-70 years of age. Their BMI had to be more or less than 24 kg/m2 and have an HbA1c more or less than 6.5%. They also had to have treatment with a diet or oral glucose lowering medication. Those needing insulin shots, had been diagnosed with chronic diseases, or had a change in diet or lifestyle 3 months prior to the study were not included in the overall

Based on the United States census, it is estimated that by the year 2050 one in three people living in the United Sates will be of Hispanic/Latino origin which include sub groups like Puerto Rican, Mexican, Cuban, Central Americans, and South Americans (Heart Association, 2014). Within those subgroups, the prevalence varied for people of Mexican descent from as high of 18.3 percent to as low as 10.3 percent for people of South American descent, Dominicans and Puerto Rican descent 18.1 percent, Central American descent and Cubans descent 13.4 percent all living in the United States with diabetes type 2. On another commentary being published in the same issue of Diabetes Care, the author wrote, “the differences in diabetes and obesity prevalence among Latinos subgroups are marked when all individuals are combined into a single group” (Heart Association, 2014). Diabetes in Latino Americans has become more prevalence with aging, by the time they reach the age of 70 years, 44.3 percent of Latino men age 70 years old to 74 years old will have develop diabetes. The same study also indicated that the longer Latino Americans live in the United States the more likely they will develop diabetes, that is according to the education and income level of the person. The study also shows

While only 7.6 percent of non-Hispanic whites and 9 percent of Asian-Americans have diabetes, 12.8 percent of Hispanics have diabetes. Other high-risk ethnic groups are non-Hispanic blacks (13.2 percent) and American Indians/Alaskan Natives (15.9 percent). For Hispanics living in the United States, the prevalence of type 2 diabetes is lower in those coming from Central and South America (8.5 percent) or Cuba (9.3 percent), but higher for those who are Mexican American (13.9 percent) and Puerto Rican (14.8 percent), who comprise the majority of Hispanic immigrants in the U.S. (Valencia, Oropesa-Gonzalez, Hogue & Florez,

Diabetes is a prevalent health disparity among the Latino population. Diabetes is listed as the fifth leading cause of death among the Latino population in the website for Center for Disease Control and Prevention, CDC, in 2009. According to McBean, “the 2001 prevalence among Hispanics was significantly higher than among blacks.” (2317) In other words among the Hispanic or Latino community, there is a higher occurrence of diabetes as compared to other racial/ethnic groups such as Blacks and Native Americans. The prevalence of diabetes among Latinos is attributed to the social determinants of health such as low socioeconomic status and level of education. Further, this becomes an important public health issue when it costs the

The Hispanic population is constantly growing and we have an estimated 13.7% of Hispanics making up the United States. “The annual percentage of patients with prediabetes in whom overt type 2 diabetes develops is about 5% in the general US population and may reach 15% in the Hispanic American population” (Idrogo & Mazze, 2004, para. 7). This a community health issue because of the percentage of Hispanic individuals that may end up with diabetes. These individuals need to be educated to help the promotion, protection, and maintenance of diabetes in this group. That is why I have created the intervention program for this ethnic group.

The Hispanic community is the largest minority in the USA and the fastest growing, It is also one with a high incidence of preventable diseases such as diabetes, periodontitis, colorectal cancer and HIV. Obesity and teenage pregnancy are significantly more prevalent in Hispanic population as well. (Crowie, 1989) Reasons for this discrepancy are many and varied, so different and varied approaches will be needed. Addressing their health care makes good public health and economic sense.

Diabetes in Hispanic Americans is a serious health challenge because of the increased prevalence of diabetes in this population, the greater number of risk factors for diabetes in Hispanics (Smith, 2010).” In the years of 2004-2006, about 11.9% of Hispanic American aged twenty (20) years or older are diagnosed with diabetes. About 75% of the Hispanic American trend to be overweight or obesity. When work with Hispanic American clients, you have to gain support from clients’ families to enhance their acceptability of the diet. Healthcare provider encourages pregnant Hispanic to eat low-fat cheeses, lean red meat, and fresh fruits and vegetables. “Gender differentiation and male dominance are issues to consider while working with Hispanic households. The father is the leader of the family while the mother runs the home, shops and prepares the food (Smith,

3. Corona, R., Gonzalez, T., Cohen, et al. “Richmond Latino Needs Assessment: A Community-University Partnership to Identify Health Concerns and Service Needs for Latino Youth”. J Community Health. 34.(2009): 195-201.

There are many health disparities that exist among the Hispanic population. Many of these are chronic conditions that affect the population. Obesity is one of the many examples of conditions that have increased for the Hispanic population. The CDC (2014) states, “The prevalence of obesity among female Mexican American adults during 2007–2010 was larger than the prevalence among female white, non-Hispanic adults during the same years” (p. 1). This is one of the many statistics that show an example of a health disparity in the Hispanic population. Another example of a problem that is prevalent in the Hispanic community is the health promotion and screening rates. The CDC (2014) states, “A smaller percentage of Hispanic adults aged 50-75 years reported being up-to-date with colorectal cancer screening in 2010 than their non-Hispanic adult counterparts”

All study participants were Mexican American from the Arizona Insulin Resistance (AIR) registry. A description of the registry has been discussed elsewhere [25]. Briefly, of the 667 participants enrolled in the study, 353 were distributed across 92 families from the AIR registry. The remaining 314 participants were found to be represented by single individuals. These 314 single, unrelated individuals were considered for the analysis because they contribute to the evaluation of covariate effects. The remaining 353 participants from 92 families generated 723 relative pairs that were distributed across fourteen relative-pair categories (Table 1). Metabolic, anthropometric, demographic and medical history information was obtained on the 667 individuals (aged 8-83 years old) enrolled in the study (Table 2). All procedures were approved by the institutional review board of Arizona State University and all subjects gave informed written consent before their participation.

What was once thought to be found only among adults has become one of the most common chronic diseases among children in the United States. Ordinarily, when diabetes strikes during childhood it is assumed to be type 1. The SEARCH for Diabetes in Youth Study began in 2000 and has provided the most comprehensive estimates of the prevalence and incidence of type 2 diabetes among youth less than 20 years of age in the US (Centers for Disease Control and Prevention, 2014). The Centers for Disease Control (CDC) reports that annually, an estimated 18,436 youth are diagnosed with type 1 diabetes, and 5,089 youth are diagnosed with type 2 among youth. In the last two decades, type 2 diabetes, has been reported among U.S. children and adolescents with increasing frequency. Disease researchers at the Centers for Disease Control and Prevention made the prediction that one in three children born in the United States in 2000 will likely develop type 2 diabetes sometime in their lifetime unless they get more exercise and improve their diets, particularly for Latino children (CDC, 2014). Without changes in diet and exercise, their odds of developing diabetes as they grow older was about 50-50.