For Scientists Research Information Alumni Connection

A. Enrique Caballero, M.D.

Dr. Caballero is a Clinical Investigator, Staff Endocrinologist and Associate Medical Director of Professional Education at Joslin Diabetes Center, as well as an Assistant Professor of  Medicine at Harvard Medical School. He is also the Director of the Joslin Latino Diabetes Initiative. He is a tutor of the culturally competent care module at Harvard Medical School. Dr. Caballero received his medical degree from the National University of Mexico Medical School, where he was awarded the Gabino Barreda Medal for being the top student in his program. He completed his residency in Internal Medicine and a fellowship in Endocrinology at the National Institute of Nutrition in Mexico. In addition, he completed a fellowship program in Endocrinology and Metabolism at the Lahey Clinic, Beth Israel Deaconess Medical Center, Joslin Diabetes Center and the Program on Clinical Effectiveness at the Harvard School of Public Health. 

Racial and ethnic minorities in the U.S. have type 2 diabetes and its complications at alarmingly high rates, according to Dr. Caballero. These rates, coupled with care disparities between these groups and the Caucasian population, offer a particular challenge to our current healthcare system; these issues form the basis for much of Dr. Caballero’s work at Joslin Diabetes Center.

The Latino Diabetes Initiative at Joslin Diabetes Center, directed by Dr. Caballero, is a comprehensive effort to improve the lives of Latinos who have or are at risk of developing diabetes. This initiative integrates a culturally oriented clinical care and patient education program, community outreach activities, professional education programs and a clinical research program. 

Dr. Caballero and team have studied the impact of multiple medical, psychological, socioeconomic and cultural factors on diabetes care among Latinos. For instance, in a recent analysis of data from the Latino Initiative, it was found that one out of three Latinos believe that insulin causes blindness. This myth among Latinos was highly correlated with a lower adherence to their diabetes treatment plan, suggesting the need to address common myths in patient care and education programs.

Dr. Caballero’s research also has identified the importance of social and family support in improving diabetes-related outcomes in Latinos with diabetes. To tackle the challenge of health disparities, not only do patient issues need to be addressed, but healthcare providers need to become more culturally competent to interact with their patients more effectively. In addition, better access to the healthcare system is needed for populations who have diabetes and its complications at these high rates.

In another study, Dr. Caballero identified that endothelial dysfunction (inflammation of the inner layer of blood vessels), considered an early event in the development of atherosclerosis, is present in overweight Hispanic children and adolescents. These findings suggest that these young individuals are at high risk of developing not only type 2 diabetes early in life, but also cardiovascular disease.

Selected References
Caballero AE. Building cultural bridges: understanding ethnicity to improve acceptance of insulin therapy in patients with type 2 diabetes. Ethnicity and Disease 16:559-568, 2006.{not able to fact check}
Caballero AE. Diabetes in minority populations. Joslin’s Diabetes Mellitus. 14th edition. Kahn CR, Weir GC, King GL, Jacobson AM, Moses AC, Smith RJ (eds). Philadelphia: Lippincott, Williams & Wilkins, pp. 505-524, 2005.

Caballero AE. Diabetes in the Hispanic or Latino population: genes, environment, culture and more. Curr Diab Rep 5:217-225, 2005.

Caballero AE. Metabolic and vascular abnormalities in subjects at risk for type 2 diabetes: the early start of a dangerous situation. Arch Med Res 36:241-249, 2005.