Consuelo wishes she could share her First Communion this year with Abuelita. She misses her grandmother very much.
Abuelita was not very old--just 62--but there was not much the doctors could do to save her life. She had uncontrolled diabetes: her kidneys were failing, her blood pressure was too high and she finally died of a heart attack.
Consuelo and Abuelita aren't actual people, but their story nevertheless is played over and over again among the more than 3 million Latinos in the Los Angeles metropolitan area, health officials say. The reason is diabetes, a silent killer that afflicts one in eight Latino adults. This rate is higher than that of any ethnic group except for American Indians.
Nationwide, it is estimated that there are more than 2 million Latinos who already have diabetes, many of them undiagnosed.
That is why the American Diabetes Assn. and other health education groups in the Los Angeles area and California have begun a major push to educate Latinos about diabetes. The effort is being aided by interested physicians and by drug companies, which make insulin and other drugs used for diabetes that can't be controlled by changes in eating habits.
Like heart disease, the adult-onset diabetes most common among Latinos is a condition that can be largely prevented with proper diet and exercise, doctors say. Being 20% or more overweight is one of the major diabetes risk factors.
"We need to get into the communities and start teaching the kids and the adolescents and the parents to make some changes in their habits," said Dr. Jaime Davidson, a Dallas physician who has spearheaded the diabetes association's Latino education efforts.
"Many people think that when Latinos come here (to the United States) they gain weight because they continue to eat the way they ate at home. But in fact, they change," Davidson said. "What happens is, fast foods are readily available . . . and they are higher in fat and calories. And at home they didn't have a car, and here instead of walking we take the car to go one block.
"That ends in having more obesity. If you have already a predisposed group of people, such as the Latinos, you get more obesity and you get more diabetes."
With funding from Upjohn Co., the Los Angeles chapter of the American Diabetes Assn. sponsored a diabetes health fair at Olvera Street Plaza on Aug. 26. Of 3,000 who attended the fair, 1,000 underwent tests for diabetes.
More of this kind of effort and wider education among the public and physicians can be expected in the future, said Janet Matkin, of the association's California affiliate.
Diabetes is a defect in the body's system for using sugar in the blood. It results from the body's failure to make insulin or, some studies indicate, from its inability to use insulin that is available.
Latinos are more than twice as likely to get diabetes than are Anglos, and incidence of the disease increases with age. In one survey done in San Antonio, a third of the Latinos between the ages of 55 and 65 had diabetes, Davidson said. Latinos' higher susceptibility is thought to result from a combination of both heredity and diet.
Similarly, American Indians have the highest diabetes incidence of any ethnic group in the United States. Genetically controlled defects in the body's insulin system are also thought to exist both for them and Latinos.
In addition, Latino diets can be rich in high-calorie fried foods that promote obesity and increase the chance of getting diabetes.
Diabetes that begins in childhood requires daily insulin injections. Most commonly in Latinos, however, diabetes takes the form called Type II, which first appears in adulthood and often can be controlled with proper diet and exercise. The disease tends to show up in the late 20s and early 30s among Latinos, a decade earlier than it does in Anglos, Davidson said.
But, because it progresses slowly, Type II diabetes can go undiagnosed for years, allowing complications such as kidney failure, heart disease, blindness and the need for amputation of a foot or toe.
Latinos, who often have less access to regular health care than Anglos, are more likely to go undiagnosed, Matkin said.
The new educational efforts to change that picture are necessary, not only because they help individuals stay healthy but also because the nation's health care funding crisis will only get worse if the problem is not reduced, Davidson said.
"We are facing a problem that is going to grow, maybe at epidemic proportions," Davidson said. "In some states like California or Texas, if nothing is done we're going to pay so much money for health care for people of Latino origin that it may become prohibitive."
The number of Latino diabetics in the United States will nearly quadruple by the year 2000 to 8 million, according to projections by Eli Lilly Co. Caring for them will cost more than $10 billion a year, even if the disease has no complications, the company projects.