According San Antonio Heart Study’s latest paper, published in the Annals of Epidemiology, diabetes is more deadly in Mexican Americans than in Anglos. And for diabetics who live in Mexico, their chances are even worse.
The study has analyzed records from thousands of patients over thirty years. It was one of the first large-scale studies to show that Mexican Americans had an increased risk of developing diabetes over Anglos.
The study’s latest paper analyzed data on the patients who had died during the study in addition to those who had died in a separate but related study by the Mexico City Diabetes Study, which included researchers from both San Antonio and Mexico.
Researchers discovered that Anglo diabetics had double the risk of dying than nondiabetics. However, Mexican American diabetics had three times the risk than nondiabetics and patients living in Mexico City had four times the risk.
“I think it’s interesting and alarming,” said Kelly Hunt, associate professor of epidemiology and biostatistics at Medical University of South Carolina in Charleston. “Although the prevalence of diabetes is so much higher in Mexican Americans than in non-Hispanic whites, it wouldn’t be all that surprising to me that if the severity of the disease was somehow worse. But it’s hard to measure that.”
Hunt, who previously worked with the University of Texas Health Science Center, noted that the study did have some limitations. The data included deaths from United States patients through only the year 2000 but included deaths in Mexico City through 2007.
Diabetics have enjoyed better treatment for the disease over the past decade, including more efficient drugs and earlier detection due to increased public awareness of diabetes. According to Hunt, the advances in diabetes treatment over the last decade put even more emphasis on the high risk of death among Mexican diabetics.
Although the large disparity in risk of death might suggest that medical treatment is not as advanced in Mexico City, the risk of death among non-diabetics was very similar across the three groups. It appears that differences in quality of medical care are not responsible for the discrepancies in risk of death among the three groups.
According to Hunt, genetic differences might play a role, making diabetes a more aggressive illness in Hispanics than in Anglo Americans. However, in that case, one would expect similar mortality rates among the Hispanics of San Antonio and Mexico City.
Dr. Roberto Treviño, researcher and director of the Social and Health Research Center in San Antonio, pointed out flaws in the paper’s findings. He referenced a 1999 paper by the San Antonio Heart Study showing that individuals who live in impoverished neighborhoods are at an increased risk of developing diabetes.
“Because living in socially deprived neighborhoods is a powerful predictor, it did not surprise me that the mortality from diabetes would be highest among Mexico City residents, Mexican Americans and non-Hispanic whites, in that order,” said Treviño. “I would argue that the cause of this health disparity is not genetic but environmental.”
The San Antonio Heart Study was designed and founded by Dr. Michael Stern. Cooperating with Dr. Clicerio Gonzalez-Villalpando of Mexico City, Stern compared diabetics living in both Mexico and the United States and found that Hispanics in San Antonio actually had higher rates of diabetes. Dr. Stern cited differences in the patients’ diets and levels of physical activity that caused Mexicans to enjoy lower rates of diabetes.
