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Educational programs have to be aimed to meet the needs of the educational level of these immigrants.

Disparities included in this population include socioeconomic status, language barriers, lack of access to healthcare and  education level.

This population has a genetic susceptibility to obesity and higher insulin resistance in their body. This population is also known for not adhering to their diabetic medication.

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·       37.3 million people have diabetes in the united states (CDC, 2022)

·       96 million people aged 18 years or older have prediabetes (CDC, 2022)

·       26.4 million people aged 65 years or older have prediabetes (CDC, 2022)

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Diabetes Statistics - Mexican Immigrants 

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Diabetes Statistics - Mexican Immigrants 

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·       Hispanic or Latino people make up a diverse group that includes people of Cuban, Mexican, Puerto Rican, South and Central American, and other Spanish cultures, and races (CDC, 2022)

·       Hispanic or Latino people are more likely to have type 2 diabetes (17%) than non-Hispanic White people (8%).

·       US adults overall, have a 40% chance of developing type 2 diabetes (CDC, 2022)

·       If you are a Hispanic or Latino adult, your chance is more than 50% of developing type 2 diabetes, and you are more likely to develop it at a younger age (CDC, 2022)

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Diabetes is the most expensive chronic condition in our nation (CDC, 2022)

$1 out of every $4 in US health care costs is spent on caring for people with diabetes (CDC, 2022)

$237 billion is spent each year on direct medical costs of diabetes (CDC, 2022)

61% of diabetes costs are for adults aged 65 or older. This cost is mainly paid by Medicare (CDC, 2022)

48% to 64% of lifetime medical costs for a person with diabetes are for complications related to diabetes, such as heart disease and stroke (CDC, 2022)

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Hispanics have increased risk of developing diabetes and also experience worse outcomes once diagnosed in comparison to non-Hispanic whites. (Fortmann et al, 2019)

This study looked at how innovative real world approaches improve clinical outcomes.

A variety of live interventions, for example those delivered in-person or by telephone without the assistance of mobile health internet technology were utilized to improve outcomes in Hispanics with type 2 diabetes. (Fortmann et al, 2019)

Technology based interventions such as text messaging, telemedicine, and Web-based tools were also utilized to improve health outcomes. (Fortmann et al, 2019)

Specifically, this study focused on the intervention of Project Dulce.

Project Dulce is an American Diabetes Association (ADA)-recognized program developed in 1997 to improve health and access to care of underserved, primarily Hispanic adults with type 2 diabetes. (Fortmann et al, 2019)

This project is nurse led and consists of a multidisciplinary team of registered dietitians, medical assistants, and educators to help deliver culturally tailored diabetes self-management education.

This project focuses on both live intervention and digital intervention.

In regard to digital intervention, the Dulce Digital intervention included culturally tailored, educational, and supportive text messages derived from the Project Dulce curriculum. (Fortmann et al, 2019)

In summary, this review shows that live and technology-based interventions largely improve behavioral and clinical outcomes in Hispanics with type 2 diabetes. (Fortmann et al, 2019)

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Mexican immigrants in the U.S. show high incidence of type 2 diabetes, and increased risk is associated with longer duration of residency. (Andrews et al, 2022)

This study was done to see the impact culture over time has for Mexican immigrant women. (Andrews et al, 2022)

Cultural consensus analysis was used to assess how aligned these Mexican immigrant women were with their cultural model. (Andrews et al, 2022)

The measurement of “cultural consonance” was explored throughout this study to understand how length of time of living in the United States affected levels of Hemoglobin A1c. (Andrews et al, 2022)

It was concluded that individuals with lower consonance are more likely to have diabetes while those who were more aligned with their culture had lower risk. (Andrews et al, 2022)

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Hispanic–Americans are disproportionately affected by type 2 diabetes compared to non-Hispanic Whites. (Titus et al, 2022)

Hispanics are twice as likely as non-Hispanic whites to die from diabetes, making it the fifth leading cause of their death in the Hispanic community. (Titus et al, 2022)

This study was done to identify what rural immigrant Latinas do to care for their diabetes health. (Titus et al, 2022)

Two themes and three sub themes were identified. Under the theme of adherence three particular activities were noted that Latinas partook in. These three activities were exercise, control of diet and medication. The second theme identified was barriers. Under barriers specifically balance of culture, lack of self-control, and cost of diet were identified. (Titus et al, 2022)

This study concludes that the Latina participants had experience and knowledge about living with diabetes, however they struggled to adhere to exercise and diet. It is believed that this is due to cultural factors and demands of the American lifestyle. (Titus et al, 2022)

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Coordination of care under one medical centered home, a method to deliver and organize healthcare that helps to improve the patient's experience of care, improve health of populations and reduce or control the costs of healthcare (Health Advantage, 2023).

Comprehensive, individualized care

Primary care, mental health services, social services, case management, specialties such as dietetics, obstetrics and gynecology

Quality and safety

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American Diabetes Association Recommendations 

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American Diabetes Association Recommendations 

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Yearly checkups

Lifestyle changes

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Provide education at community centers

Information about food groups (Basiak-Rasała, Różańska & Zatońska, 2019)

Increasing aerobic exercise (Magkos, Hjorth, & Astrup, 2020)

Free clinic accessibility and annual physicals

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Engage with community, form connections

Connect with community centers

Involve other members of interdisciplinary team

Further study

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The incidence of diabetes in the Mexican-American immigrant community, and at times the improper management thereof, has become a prevalent issue in the United States. Not only are members of the Latinx population subject to modifiable risk factors such as diet in a country where unhealthy foods are cheap and easily accessible, but non-modifiable factors such as language-barriers and impeded access to healthcare.

As the future of healthcare, we must take active steps to advocate for the underserved populations. Implementing healthcare models like PCMHs impacts accessibility to healthcare as well as the overall well being of the population.

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American Diabetes Association (2019). Standards of Medical Care in Diabetes-2019 Abridged for Primary Care Providers. Clinical diabetes : a publication of the American Diabetes Association, 37(1), 11–34. https://doi.org/10.2337/cd18-0105

Andrews, C., Oths, K. S., & Dressler, W. W. (2022). Time in the United States and diabetes among Mexican immigrant women: The moderating role of culture. Journal of Migration and Health, 6, 100118. https://doi.org/10.1016/j.jmh.2022.100118

Aguayo-Mazzucato, C., Diaque, P., Hernandez, S., Rosas, S., Kostic, A., & Caballero, A. E. (2019). Understanding the growing epidemic of type 2 diabetes in the Hispanic population living in the United States. Diabetes/metabolism research and reviews, 35(2),     e3097. https://doi.org/10.1002/dmrr.3097

Basiak-Rasała, A., Różańska, D., & Zatońska, K. (2019). Food groups in dietary prevention of type 2 diabetes. Roczniki Panstwowego Zakladu Higieny, 70(4), 347–357. https://doi.org/10.32394/rpzh.2019.0086

Centers for Disease Control and Prevention. (2022a, December 21). Health and economic benefits of diabetes interventions. Centers for Disease Control and Prevention. https://www.cdc.gov/chronicdisease/programs-impact/pop/diabetes.htm

Centers for Disease Control and Prevention. (2022b, April 4). Hispanic or Latino people and type 2 diabetes. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/library/features/hispanic-diabetes.html

Centers for Disease Control and Prevention. (2022c, June 29). National Diabetes Statistics Report. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/data/statistics-report/index.html

Concha, J. B., Kelly, K., & Mezuk, B. (2021). Hispanic/latino ethnic identity and diabetes: An examination of underlying acculturation processes and the Hispanic/Latino Health Advantage. Health Education &amp; Behavior, 48(3), 285–294. https://doi.org/10.1177/10901981211010083

Filler, T., Jameel, B., & Gagliardi, A. R. (2020). Barriers and facilitators of patient centered care for immigrant and refugee women: A scoping review. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-09159-6

Fortmann, A. L., Savin, K. L., Clark, T. L., Philis-Tsimikas, A., & Gallo, L. C. (2019). Innovative diabetes interventions in the U.S. Hispanic population. Diabetes Spectrum, 32(4), 295–301. https://doi.org/10.2337/ds19-0006

Health Advantage. (2023). Benefits of a PCMH. HealthAdvantage. https://www.healthadvantage-hmo.com/providers/resource-center/value-based-programs/benefits-of-a-pcmh

Magkos, F., Hjorth, M. F., & Astrup, A. (2020). Diet and exercise in the prevention and treatment of type 2 diabetes mellitus. Nature reviews. Endocrinology, 16(10), 545–555. https://doi.org/10.1038/s41574-020-0381-5

Titus, S. K., & Quiles–Pollard, G. (2022). A study of immigrant latinas perspectives of caring for their diabetes. Journal of Racial and Ethnic Health Disparities. https://doi.org/10.1007/s40615-022-01404-5

Vidal, T. M., Williams, C. A., Ramoutar, U. D., & Haffizulla, F. (2022). Type 2 Diabetes Mellitus in Latinx Populations in the United States: A Culturally Relevant Literature Review. Cureus, 14(3), e23173. https://doi.org/10.7759/cureus.23173