Gianfrancesco Fiorini1, Silvano Milani2, Angela I Pincelli3, Damiano Calella3, Silvia Galliani3, Silvia Badalamenti4, Antonello E Rigamonti2, Nicoletta Marazzi5, Alessandro Sartorio5, Silvano G Cella6. 1. Istituti Clinici Zucchi, Gruppo San Donato, Carate Brianza, Italy. 2. Department of Clinical Sciences and Community Health, University of Milan, Italy. 3. Endocrinology and Diabetes Center, San Gerardo Hospital, Monza, Italy. 4. Osservatorio Donazione Farmaci, Banco Farmaceutico Foundation, Italy. 5. Istituto Auxologico Italiano, Laboratory for Auxo-endocrinological Research, Milano and Verbania, Italy. 6. Department of Clinical Sciences and Community Health, University of Milan, Italy; Osservatorio Donazione Farmaci, Banco Farmaceutico Foundation, Italy. Electronic address: silvano.cella@unimi.it.
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.
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.
Authors: Gianfrancesco Fiorini; Ivan Cortinovis; Giovanni Corrao; Matteo Franchi; Angela Ida Pincelli; Mario Perotti; Antonello Emilio Rigamonti; Alessandro Sartorio; Silvano Gabriele Cella Journal: Int J Environ Res Public Health Date: 2020-11-05 Impact factor: 3.390