Language Barrier May Keep Some Hispanics From Good Diabetes Care

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Studies found poor doctor-patient communication hampered medication use, proper blood sugar control

Hispanic-American type 2 diabetes patients who lack proficiency in English may end up with poorer care, a new study finds.

Specifically, these patients were found to be much less likely than non-Hispanic patients to take newly prescribed diabetes medications as directed, the researchers said.

The study “suggests that more needs to be done to improve adherence to newly prescribed medications among Latino patients at all levels of English proficiency,” wrote a team led by Dr. Alicia Fernandez, of the University of California, San Francisco.

A diabetes specialist who reviewed the study wasn’t surprised by the results.

The research “further validates what many clinicians already know: Patients who do not understand English tend to do worse with management of chronic disease,” said Dr. Maria Pena. She is an endocrinologist who directs the Center for Weight Management at Lenox Hill Hospital in New York City.

According to background information in the study, more than 3.1 million Hispanics in the United States have diabetes and must take medication every day.

For the research, Fernandez’s team tracked data from nearly 31,000 insured patients in California.

The study found that more than 60 percent of Spanish-speaking Hispanic patients did not take newly prescribed diabetes drugs as directed. That’s compared to about 52 percent of English-speaking Hispanics, and 37.5 percent of white patients, the researchers said.

“Our study among insured patients suggests that more needs to be done to improve adherence to newly prescribed medications among Latino patients at all levels of English proficiency,” Fernandez and her co-authors wrote.

The study was published Jan. 23 in JAMA Internal Medicine.

Another study in the same issue of the journal was led by Melissa Parker of Kaiser Permanente in Oakland, Calif. Her team found that blood sugar control could improve for Hispanic type 2 diabetes patients with limited English skills — but only when they switched from a primary care doctor who only spoke English to a doctor who primarily spoke Spanish to his or her patients.

Pena called diabetes treatment a “complex” issue that requires clear understanding between doctor and patient, if it is to succeed.

She said that “in some cases, treatment may require frequent checking of finger sticks to monitor sugar levels, injecting medications such as insulin, and knowing how to calculate the amount of insulin necessary based on the amount of carbs consumed.”

And while the new studies focused on Spanish-speaking patients with type 2 diabetes, Pena believes the results probably hold true for “any disease that requires long-term monitoring and follow-up.”

SOURCES: Maria E. Pena, M.D., endocrinologist and director, Center for Weight Management, Lenox Hill Hospital, New York City; JAMA Internal Medicine, news release, Jan. 23, 2017

Last Updated: Jan. 23, 2017

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