Approximately 5.5 million Latinas suffer from elevated fasting plasma glucose (FPG) and nearly 4 million of those women were never told by a healthcare provider they were at risk for diabetes, pre-diabetes, or were borderline for diabetes.
The study, "Latinas with Elevated Fasting Plasma Glucose: An Analysis Using NHANES 2009-2010 Data," led by Dr. Shiela M. Strauss, Associate Professor, New York University College of Nursing (NYUCN), points to the urgent need for alternate sites of opportunity for diabetes screenings. There is also a need for effective and culturally sensitive follow-up care and case management.
"Almost 1 million of these 4 million Latinas had not seen a doctor or other healthcare provider in the past 12 months," explains Dr. Strauss. "This is of particular concern as it eliminates a potential opportunity for them to learn about their diabetes risk and their elevated FPG before it causes serious avoidable harm."
The study's data were drawn and analyzed from the National Health and Nutrition Examination Survey (NHANES) 2009-2010. The researchers examined data from 1,467 women—Hispanic, non-Hispanic White and non-Hispanic Black women—who were all given a physical examination and participated in interviews that asked questions about their socioeconomic status and demographic and health-related issues. The researchers looked at how many women reported never being told by a health provider that they were at risk of diabetes, had pre-diabetes, or were borderline for diabetes. They then analyzed data from Hispanic subgroups, as cultural differences may argue for the development of different diabetes-related health-preserving strategies.
"In addition to our finding regarding lower health care utilization for Latina women, the finding that the majority of women with elevated FPG levels who had not been told they were at risk, even among those with higher levels of contact with a health care provider, indicates the urgent need to incorporate diabetes screening and culturally competent care across a broader range of health care visits," said Sherry Deren, Ph.D., Director, CDUHR and Senior Research Scientist, College of Nursing, a co-author on the study. "Incorporating this assessment as part of most (if not all) health care visits is likely to increase the early identification of women who are at risk for diabetes."
Latina women are at considerable risk for complications from diabetes. Their fear of, and cultural misconceptions concerning diabetes, together with their lack of understanding of diabetes risks makes diabetes screening and self-care a challenge. The study suggests considering alternative sites like optometry venues, pharmacies, dental visits, mobile delivery via health vans, or even places of worship in order to increase access, education, and culturally sensitive self-management programs.
"With the proportion of Latinas with diabetes expected to rise dramatically, there is an urgent need for increased efforts to enhance use of traditional health services by Latinas, and to develop alternate sites for diabetes screening," said Dr. Helene D. Clayton-Jeter, Director, Cardiovascular and Endocrine Liaison Program, Office of Health and Constituent Affairs, U.S. Food and Drug Administration, a co-author on the study. "There is also a critical need for effective strategies that are considerate of culture and language preferences, including case management, extended follow up care, and a team approach for supporting Latinas and others with pre-diabetes and diabetes in order to respond to an increasingly serious public health threat."
"Unfortunately, adults with undiagnosed pre-diabetes and diabetes are denied the opportunity to receive support and treatment to avert the onset and progression of serious diabetes-related complications," states Dr. Strauss, "As public health care providers, we must make the creation of targeted programs to encourage Latinas to get screened for diabetes a priority."
The study appears in Hispanic Health Care International, Vol.12:1, March 2014.