A New Era in Understanding Diabetes Disparities Among U.S. Latinos—All Are Not Equal

Latinos currently comprise 15% of the U.S. population. It is estimated that by 2050, 1 out of 3 U.S. residents will be Latino (1). The Latino population is a heterogeneous mix of people born in and outside the U.S., with different social, cultural, and behavioral attitudes that may affect health. The prevalence of diabetes in adults over the age of 20 years is higher among Latinos compared with non-Hispanic whites (2). However, the differences in diabetes and obesity prevalence among Latino subgroups are masked when all individuals are combined into a single group. Specifically, the higher overall diabetes prevalence is driven by Puerto Rican and Mexican Americans, while Cuban, Central, and South Americans have similar prevalence to non-Hispanic whites (2,3). The Endocrine Society’s Scientific Statement on Health Disparities in Endocrine Disorders identified that “a major gap in our current understanding of race/ethnic disparities in endocrine disorders is a failure of most studies to specify Hispanic-American and Asian-American subgroups” and recommended that “future studies accurately identify ethnic subgroups” (2). The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is the first U.S. population-based study to address this knowledge gap with 16,415 Latino women and men (3,4). Prior to the creation of this cohort, the Centers for Disease Control and Prevention was unable to estimate the total prevalence of diabetes among Latinos (5). In this issue, two articles published from the HCHS/SOL fill in this void in diabetes epidemiology (5,6). Both articles demonstrate high prevalence of diabetes and the metabolic syndrome among Latinos, and their major strength is highlighting the heterogeneity in prevalence among U.S. Latinos of diverse origins. …