Pre-Diabetes in the Hispanic Population: Adolescents to Adulthood

Research Article

Ann Nurs Res Pract. 2019; 4(1): 1032.

Pre-Diabetes in the Hispanic Population: Adolescents to Adulthood

Woods T1* and Dr. Nies MA2

¹Graduate Teaching Assistant and PhD Candidate, Idaho State University, Pocatello, USA

²Director of Nursing Research and College of Nursing Professor, Idaho State University, Pocatello, USA

*Corresponding author: Tanna Woods, Idaho State University, Graduate Teaching Assistant, W Eurasian Crane Road, Clinton, UT, 921 South 8th Avenue Stop 8101, Pocatello ID 83209-8101, USA

Received: March 19, 2019; Accepted: April 24, 2019; Published: May 01, 2019


Background: Preventing prediabetes from developing into diabetes has led to successful programs like the Diabetes Prevention Program, although translation to minority populations is not readily available. Since minorities endure a disproportionate effect from diabetes and its complications, finding tailored interventions that work for minorities to prevent prediabetes is crucial. This review sought to understand successful interventions to prevent prediabetes in Hispanics across the lifespan.

Methods: Searching four electronic databases yielded 1,606 articles relating to prediabetes interventions in Hispanics. This was narrowed to 21 studies for full review.

Results: Cultural tailoring of programs has included promotoras, bilingual presenters, and specific focus on cuisine/recipe modification for adults. In adolescents, fewer applications are noted, though success has been seen using social media and by with mixed approaches of diet/activity.

Discussion: Culturally tailoring programs to the Hispanic population can effectively reduce risks by reducing weight and A1C. Further study, especially relating to interventions for adolescents, needs to be done to affect their risk for diabetes.

Keywords: Prediabetes; Hispanic or Latino; Adolescents; Adult; Intervention


The need to focus on those with prediabetes and start preventative measures to stop disease progression is accentuated by an increased prevalence across the lifespan and an overrepresentation of minority populations being affected.

Prediabetes is usually an asymptomatic condition that is diagnosed with an A1C of 5.7% to 6.4% or a fasting blood sugar of 100mg/dl to 125mg/dl [1]. This condition affects 84.1 million adults in the United States, equating to 33.9% of the adult population [2]. Nearly half (48.3%) of adults aged 65 or older have prediabetes [3]. Lack of intervention via lifestyle changes, medication, or both increases the chance of progression from prediabetes to Type 2 Diabetes Mellitus (T2DM) each year by 5% to 10% compared to 2% of those with normoglycemia [4]. The trajectory for T2DM is expected to continue climbing in the United States with a projected increase of 198% between 2005 and 2050 generally and a 481% increase in Hispanic populations [5].

Part of the risk of developing T2DM is linked to increased weight. Projections estimate that more than half of today’s youth will be obese by the age of 35 if trends continue [6]. In minority youth, the percent of youth who have obesity are increased in minorities. For example, 22.5% of black youth, 20.6% of Hispanic youth, and 6.4% of Asian youth are obese [6].

These youth with overweight and obesity status have a greater risk for T2DM. If prediabetes transitions into T2DM, it can equate to a high cost. Total costs associated with diagnosed diabetes mellitus was $327 billion in the United States in 2017 [7]. This cost is comprised of $237 billion in direct medical cost and $90 billion in reduced productivity [7].

As those diagnosed with prediabetes have an increased risk of up to 70% of developing T2DM [8], it is imperative to intervene. Prediabetes interventions have been identified in the general population based on whether a person has Impaired Fasting Glucose (IFG) versus Impaired Glucose Tolerance (IGT) [9]. Engaging in diet and exercise was shown to reduce the risk of T2DM by 58% in those with IFG and IGT in a United States sample, while the use of metformin 850mg twice daily can lower risk 31% [9]. The 58% held steady in a Finnish study examining the effect of diet and exercise relating to IGT, though dropped to 28.5% in an Indian population [9].

While general studies have shown the positive effects associated with diet and lifestyle changes, specific barriers to change and the burden of socioeconomic inequalities that can affect the success of interventions need to be better understood, especially in high-risk minority groups [9]. This is especially true for youth who experience a 15-year reduction in their life expectancy when they are diagnosed with T2DM, thus having a ripple effect and burden on the workforce, healthcare, and the economy [10].

The risk of developing T2DM has been linked to escalating obesity rates and inactivity [11]. In fact, obesity and diabetes have been called the twin epidemic as eating, physical activity, and weight control are linked to both diagnoses [12]. Increasing diabetes prevalence is concurrent with increasing obesity with projections that 42% of Americans could be obese by 2030 and 33% of adults could have diabetes by 2050 [12].

Intervention using the National Diabetes Prevention Program (NDPP) most notably have been found to be successful in adults, though there is limited study on what impact intervention can have specifically for the Hispanic population in adolescents [10]. By 2011, only six interventions had translated the successful NDPP lifestyle intervention to minority populations with three looking at African American populations and zero focusing on Hispanic populations [13].

This review sought to answer three questions. First, are specific interventions being created for the Hispanic population to reduce the progression of prediabetes in adolescence or adulthood? Second, are the interventions effective? Third, what still needs to be answered regarding the Hispanic population and prediabetes?

Materials and Methods

Four electronic databases were searched between August and October 2018: CINAHL, EBSCOhost, PubMed, and One search. One search is an engine that simultaneously searches the library database, then ranks results by relevance to search terms. In addition to these searches, references of included articles were also searched, which yielded another 26 articles for examination. Figure 1 shows how article selection and rejection occurred.

Citation: Woods T and Nies MA. Pre-Diabetes in the Hispanic Population: Adolescents to Adulthood. Ann Nurs Res Pract. 2019; 4(1): 1032.