Fedeli U, Casotto V, Ferroni E, Saugo M, Targher G, Zoppini G
Epidemiological Department, Veneto Region, Italy.
Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Italy.
Nutr Metab Cardiovasc Dis. 2015 Oct;25(10):924-30. doi: 10.1016/j.numecd.2015.06.010. Epub 2015 Jul 3.
Type 2 diabetes, one of the most important non-communicable diseases, represents a major health problem worldwide. Immigrants may contribute relevantly to the increase in diabetes. The aim of the study was to investigate variability in diabetes prevalence across different immigrant groups in the Veneto Region (northeastern Italy).
Diabetic subjects on January 2013 were identified by record linkage of hospital discharge records, drug prescriptions, and exemptions from medical charges for diabetes. Immigrant groups were identified based on citizenship. Age-standardized prevalence rates were obtained for residents aged 20-59 years by the direct method, taking the whole regional population as reference. Prevalence rate ratios (RR) with 95% Confidence Intervals (CI) were computed with respect to Italian citizens. Among residents aged 20-59 years, 45280 Italian and 7782 foreign subjects affected by diabetes were identified. Prevalence rates were highest among immigrants from South-East Asia, RR 4.9 (CI 4.7-5.1) among males, and 7.6 (7.2-8.1) among females, followed by residents from both North and Sub-Saharan Africa. Citizens from Eastern Europe (the largest immigrant group) showed rates similar to Italians. Most South-Asian patients aged 20-39 years were not insulin-treated, suggesting a very high risk of early onset type 2 diabetes in this ethnic group.
Large variations in diabetes prevalence by ethnicity should prompt tailored strategies for primary prevention, diabetes screening, and disease control. An increased demand for prevention and health care in selected population groups should guide appropriate resource allocation.
2型糖尿病是最重要的非传染性疾病之一,是全球主要的健康问题。移民可能对糖尿病发病率的上升有显著影响。本研究的目的是调查意大利东北部威尼托地区不同移民群体中糖尿病患病率的差异。
通过医院出院记录、药物处方和糖尿病医疗费用豁免的记录链接,确定了2013年1月的糖尿病患者。根据公民身份确定移民群体。以整个地区人口为参照,采用直接法得出20至59岁居民的年龄标准化患病率。计算相对于意大利公民的患病率比(RR)及其95%置信区间(CI)。在20至59岁的居民中,确定了45280名患糖尿病的意大利人和7782名外国人。东南亚移民的患病率最高,男性RR为4.9(CI 4.7 - 5.1),女性为7.6(7.2 - 8.1),其次是来自北非和撒哈拉以南非洲的居民。来自东欧的公民(最大的移民群体)患病率与意大利人相似。大多数20至39岁的南亚患者未接受胰岛素治疗,表明该族群2型糖尿病早发风险极高。
不同种族间糖尿病患病率的巨大差异应促使制定针对性的一级预防、糖尿病筛查和疾病控制策略。特定人群对预防和医疗保健需求的增加应指导合理的资源分配。