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Article ; Online: Will undocumented migrants contribute to change epidemiology, presentation and pharmacologic treatment of diabetes in Western countries?

Fiorini, Gianfrancesco / Milani, Silvano / Pincelli, Angela I / Calella, Damiano / Galliani, Silvia / Badalamenti, Silvia / Rigamonti, Antonello E / Marazzi, Nicoletta / Sartorio, Alessandro / Cella, Silvano G

Primary care diabetes

2019  Volume 14, Issue 1, Page(s) 21–28

Abstract: Aims: Migrants from countries in which health and social conditions are unsatisfactory, and their offspring, are becoming a growing component of the western population. Available health data show that their morbidity is at least comparable to that of ... ...

Abstract Aims: Migrants from countries in which health and social conditions are unsatisfactory, and their offspring, are becoming a growing component of the western population. Available health data show that their morbidity is at least comparable to that of the host country population, with a significant contribution of chronic diseases as diabetes. The possibility that diabetes shows different features in undocumented migrants is the hypothesis that we tried to investigate in this study.
Methods: We retrospectively analysed the data of 413 patients with type 2 diabetes mellitus (T2DM): 222 patients followed in a diabetes clinic at a University Hospital and 191 undocumented migrants cared for by a Charity in Milan, Italy.
Results: We found that the onset of the disease was earlier in migrants; they showed a significant lower body mass index (BMI) and had lower socioeconomic conditions. They had a worse glycaemic control. The pattern of complications was also different between the two groups, with cardiovascular complications more frequent in Italians. Finally, also pharmacologic treatment differed significantly.
Conclusions: Age of onset, clinical manifestations and complications of T2DM in undocumented migrants and natives may show significant differences. This is important for both epidemiological and clinical reasons. If these preliminary observations are confirmed by larger studies, we can conclude that undocumented migrants should be screened for T2DM earlier than natives, and that therapies should be tailored to the specific features of their disease.
MeSH term(s) Adult ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/epidemiology ; Female ; Health Status Disparities ; Healthcare Disparities ; Humans ; Hypoglycemic Agents/therapeutic use ; Italy/epidemiology ; Male ; Middle Aged ; Retrospective Studies ; Social Determinants of Health ; Socioeconomic Factors ; Undocumented Immigrants
Chemical Substances Hypoglycemic Agents
Language English
Publishing date 2019-05-04
Publishing country England
Document type Comparative Study ; Journal Article
ZDB-ID 2273997-X
ISSN 1878-0210 ; 1751-9918
ISSN (online) 1878-0210
ISSN 1751-9918
DOI 10.1016/j.pcd.2019.04.004
Database MEDical Literature Analysis and Retrieval System OnLINE

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