Better understanding type 2 diabetes factors in older Hispanic people

Hispanic people over the age of 60 are a rapidly growing demographic group that is disproportionately affected by type 2 diabetes and the factors that drive its development. However, despite a clear understanding of how diet, exercise and other lifestyle factors matter when controlling diabetes, there is a shortage of research on self-care behaviors in this group, which is projected to make up more than 20 percent of the U.S. population by 2060.

To help fill this gap, a team of researchers led by Nelda Mier, PhD, associate professor at the Texas A&M School of Public Health McAllen campus, investigated overweight and obese older Hispanics with type 2 diabetes in the Texas-Mexico border region. The study, published in the journal Sage Open, examined healthy eating and exercise habits and characteristics such as sex, marital status, family support and education using survey questions and demographic data from a 2008 cross-sectional study in Hidalgo County, Texas, which is 84 percent Hispanic and one of the poorest counties in the United States

Type 2 diabetes can bring reduced quality of life and complications such as kidney disease, heart attack and stroke. Sometimes referred to as a lifestyle disease, type 2 diabetes is significantly influenced by obesity, poor diet and low levels of physical activity.

“There are disparities in these factors among older Hispanics, who are less likely to report walking or engaging in physical activity than non-Hispanic adults,” Mier said. “This may contribute to the higher prevalence of type 2 diabetes in older Hispanics than the overall population.”

The researchers surveyed overweight and obese older Hispanics with type 2 diabetes, asking how many days during the past week they had followed a healthy eating plan, eaten five or more servings of fruits and vegetables and participated in at least 30 minutes of physical activity. The responses were broken out by age group (60–64, 65–74 and 75 and older), sex, marital status, education level and being overweight or obese.

Researchers found that married males who had a high school education and received some form of diabetes education had the highest reported levels of exercise. In addition, respondents who had taken diabetes education courses and had a more supportive family environment reported having healthier eating habits. These findings add to the body of knowledge on self-care behaviors in this population and support previous studies on how personal and social factors influence healthy lifestyles.

The differences in exercise scores between married males with a high school education and other groups indicates areas to focus additional efforts promoting physical activity in those of other demographics, such as unmarried people, women and those with lower educational achievement. Also, about two-thirds of respondents reported having never received diabetes education, which shows a need to better target diabetes education materials for older Hispanics. Lastly, the study found a significant association between family support and self-care, with only about half of participants saying they had high levels of support. This demonstrates the importance of involving entire families in diabetes education efforts and the role that families play in things like meal planning, transportation and encouraging healthy behaviors.

“Although these findings are not generalizable to the overall population due to the lack of comparison groups and the self-reported nature of the study, they do clarify areas for improvement in diabetes interventions and shine a light on future research avenues,” Mier said. “For example, how community centers and outreach groups can provide better diabetes education, how walkability and the presence of exercise facilities affects physical activity levels and how the availability of healthy food—or lack thereof in food deserts—influences healthy eating.”

Such studies could help the public health research community build a more comprehensive view of the issue and help to improve the health of a growing part of the population.