Cross-cultural communication crucial to treating Hispanic, Latino patients with diabetes
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Providers should take an individualized approach and spend more time listening when treating Hispanic and Latino patients with type 2 diabetes, according to a speaker at the Cardiometabolic Health Congress virtual meeting.
“The recommendation is to appreciate the [Hispanic] culture, understand a lot of things that are common without creating stereotypes,” A. Enrique Caballero, MD, endocrinologist and clinical investigator, director of Latino diabetes health in the division of endocrinology, diabetes and hypertension at Brigham and Women’s Hospital; faculty director of the International Innovation Programs in the office for external education at Harvard Medical School; and chair for the Health Care Disparities Committee at the American Diabetes Association, told Healio. “In the end, appreciate each individual as a person, regardless of race or ethnicity, and try to learn more about that person.”
The Hispanic population the largest historically underrepresented group in United States at 16.3% of the population as of the 2010 U.S. Census, and the number is expected to keep growing. U.S. Census projections have the Hispanic population accounting for 20% of the U.S. population by 2025 and 25% by 2045.
Additionally, 23% of Hispanic individuals have type 2 diabetes, similar to the prevalence found in Asian and Black people and more than double the 11% prevalence found in white people. Caballero also noted 49% of Hispanic people have undiagnosed type 2 diabetes vs. 32% of white individuals.
There are several obstacles Hispanic and Latino patients face in managing type 2 diabetes. Caballero said that genetic and biological factors should be considered in diabetes clinical practice.
“There are some genetic and biological factors that influence the development of type 2 diabetes in this community,” Caballero told Healio. “We know that there is more insulin resistance. There is also the tendency of the accumulation of interior abdominal fat that we know is deleterious. We also know the beta cells in the pancreas may get tired more easily in this community.”
Another issue is some Hispanic patients with type 2 diabetes may not have access to proper nutrition and may have limited financial resources. Caballero said providers need to work with each individual to find out how they can best acquire foods for a healthy diet.
Emotional stress, depression, and fears are also obstacles for Hispanics with type 2 diabetes. Caballero discussed how group medical visits may help ease some of the fears the community faces with diabetes management.
“These are not classes,” Caballero said in the presentation. “These are not only education activities. These are medical visits that are implemented in a group setting. The idea here is that people can share their experience as you do your work. It’s a nice interaction and people motivate each other.”
Caballero emphasized the importance for providers to establish better cross-cultural communication with Hispanics. This involves not just speaking to each person they treat, but also listening to them.
“As health care providers, we need to become more humble,” Caballero said in the presentation. “We need to listen to patients. We need to get closer to them. We need to understand and respect their culture, their background, their ideas, and not to impose our ideas all of the time.”
References:
Caballero AE. Front Endocrinol. 2018;doi:3389/fendo.2018.00479.
Caballero AE. Endocr Pract. 2019;doi:10.4158/EP-2019-0281.
Menke A, et al. JAMA. 2015;doi:10.1001/jama.2015.10029.
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Caballero AE. Managing T2D in the Hispanic/Latino Population. Presented at: Cardiometabolic Health Congress; Oct. 21-24, 2020 (virtual meeting).
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