【2h】

From Sea to Shining Sea and the Great Plains to Patagonia: A Review on Current Knowledge of Diabetes Mellitus in Hispanics/Latinos in the US and Latin America

机译:从大海到光辉的大海,再从大平原到巴塔哥尼亚:美国和拉丁美洲的西班牙裔/拉丁美洲裔对糖尿病的最新认识

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摘要

The past two decades have witnessed many advances in the prevention, treatment, and control of diabetes mellitus (DM) and its complications. Increased screening has led to a greater recognition of type 2 diabetes mellitus (type 2 DM) and prediabetes; however, Hispanics/Latinos, the largest minority group in the US, have not fully benefited from these advances. The Hispanic/Latino population is highly diverse in ancestries, birth places, cultures, languages, and socioeconomic backgrounds, and it populates most of the Western Hemisphere. In the US, the prevalence of DM varies among Hispanic/Latino heritage groups, being higher among Mexicans, Puerto Ricans, and Dominicans, and lower among South Americans. The risk and prevalence of diabetes among Hispanics/Latinos are significantly higher than in non-Hispanic Whites, and nearly 40% of Hispanics/Latinos with diabetes have not been formally diagnosed. Despite these striking facts, the representation of Hispanics/Latinos in pharmacological and non-pharmacological clinical trials has been suboptimal, while the prevalence of diabetes in these populations continues to rise. This review will focus on the epidemiology, etiology and prevention of type 2 DM in populations of Latin American origin. We will set the stage by defining the terms Hispanic, Latino, and Latin American, explaining the challenges identifying Hispanics/Latinos in the scientific literature and databases, describing the epidemiology of diabetes—including type 2 DM and gestational diabetes mellitus (GDM)—and cardiovascular risk factors in Hispanics/Latinos in the US and Latin America, and discussing trends, and commonalities and differences across studies and populations, including methodology to ascertain diabetes. We will discuss studies on mechanisms of disease, and research on prevention of type 2 DM in Hispanics/Latinos, including women with GDM, youth and adults; and finalize with a discussion on lessons learned and opportunities to enhance research, and, consequently, clinical care oriented toward preventing type 2 DM in Hispanics/Latinos in the US and Latin America.
机译:在过去的二十年中,糖尿病(DM)及其并发症的预防,治疗和控制取得了许多进展。越来越多的筛查导致人们对2型糖尿病(2型DM)和糖尿病前期患者有了更多的认识。但是,美国最大的少数族裔西班牙裔/拉丁美洲人尚未从这些进步中充分受益。西班牙裔/拉美裔人口的祖先,出生地,文化,语言和社会经济背景各不相同,并且遍布西半球的大部分地区。在美国,DM的患病率在西班牙裔/拉丁美洲裔之间有所不同,墨西哥人,波多黎各人和多米尼加人较高,而南美人较低。西班牙裔/拉丁美洲人中糖尿病的患病率和患病率显着高于非西班牙裔白人,并且近40%的西班牙裔/拉丁美洲人糖尿病没有得到正式诊断。尽管有这些惊人的事实,但在药理和非药理临床试验中,西班牙裔/拉丁裔的代表性仍不理想,而这些人群中糖尿病的患病率仍在上升。这篇综述将侧重于拉丁美洲起源人群的2型糖尿病的流行病学,病因学和预防。我们将通过定义“西班牙裔”,“拉丁裔”和“拉丁美洲”这几个词为舞台做准备,解释科学文献和数据库中识别西班牙裔/拉丁裔的挑战,描述2型糖尿病和妊娠糖尿病(GDM)等糖尿病的流行病学,以及美国和拉丁美洲的西班牙裔/拉丁美洲裔的心血管危险因素,并讨论研究与人群之间的趋势,共性和差异,包括确定糖尿病的方法。我们将讨论在西班牙裔/拉丁美洲人中,包括患有GDM的妇女,青年和成人,对疾病机理的研究以及对2型DM的预防研究;并最后就获得的经验教训和加强研究的机会进行讨论,因此,在美国和拉丁美洲的西班牙裔/拉丁美洲人中,以预防2型糖尿病为重点的临床护理。

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