Prevalence and management of diabetes in immigrants resident in the Lombardy Region: the importance of ethnicity and duration of stay

Acta Diabetol. 2018 Apr;55(4):355-362. doi: 10.1007/s00592-018-1102-6. Epub 2018 Jan 22.

Abstract

Aims: To describe the prevalence and management of diabetes among immigrants according to ethnic group and duration of stay, compared to Italian citizens.

Methods: Diabetic immigrant and Italian residents aged 20-69 years in the administrative database of the Lombardy Region. Immigrants were classified by region of origin and as long-term residents (LTR) and short-term residents (STR). Age- and sex-adjusted prevalence and indicators of diabetes management were calculated for immigrants by region of origin and by length of stay using Cox proportional models.

Results: In 2010 19,992 immigrants (mean age 49.1 ± 10.8, 53.7% males) and 195,049 Italians (mean age 58.7 ± 9.3, 61.1 males) with diabetes were identified. Immigrants had a higher adjusted diabetes prevalence than Italians (OR 1.48; 95% CI 1.45-1.50). STR received significantly fewer recommended cardiovascular drugs (antiplatelets, statins and ACE-inhibitors/ARBs) than Italians, although prescription was higher among LTR from some ethnic groups. Immigrants were less likely to be seen by a diabetologist and to do at least one HbA1c test per year. Although the recommended tests/visits were more often done for the LTR than the STR, in the majority of ethnic groups these indicators were still far from optimal.

Conclusion: The prevalence and management of diabetes differ between immigrants and Italians, although some improvement can be seen among LTR.

Keywords: Diabetes management; Diabetes prevalence; Ethnicity; Migration.

MeSH terms

  • Adult
  • Aged
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / ethnology
  • Diabetes Mellitus / therapy*
  • Emigrants and Immigrants / statistics & numerical data*
  • Ethnicity / statistics & numerical data*
  • Female
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Time Factors
  • Young Adult