法国患有糖尿病的成年移民：家庭移民的影响。
Migrant adults with diabetes in France: Influence of family migration.
作者信息
Chambre C, Gbedo C, Kouacou N, Fysekidis M, Reach G, Le Clesiau H, Bihan H
机构信息
Department of Endocrinology, Diabetology, Metabolic Disease, AP-HP, Avicenne Hospital, 127 route de Stalingrad, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, Bobigny, France.
Centre d'Examens de Santé de la Caisse Primaire d'Assurance Maladie de Seine-Saint-Denis, 2 avenue de la Convention, 93009 Bobigny, France.
出版信息
J Clin Transl Endocrinol. 2016 Dec 10;7:28-32. doi: 10.1016/j.jcte.2016.12.003. eCollection 2017 Mar.
AIM
To explore the influence of migration and this parameters on the control of diabetes.
METHODS
A cohort of migrant patients with type 2 diabetes was recruited in a center affiliated to the French national insurance system situated in a department with important migratory phenomenon. Patients fulfilled a questionnaire about diabetes, their migration history, and the EPICES score (deprivation score). We have explored by univariate and multivariate analysis if any of the characteristics of migration could be related to the control of diabetes. This cohort was compared to a non-migrant control group of age and sex-matched patients.
RESULTS
We included 72 patients, 36 women and 36 men from 20 different countries. The mean age was 57.7 ± 9.6 years. A migration for family reunification was associated with better diabetes equilibrium (Risk of having an HbA1c ⩾8% (63.9 mmol/mol): OR 0.07 (95% IC [0.005-0.86], p = 0.04). The migrant patients who wished to share their time between France and country of origin during their retirement had a better glycaemic control than the migrant patients who would like to go alone into their country (OR 0.08 [0.01-0.78], p = 0.03). Compared to the non migrant group, the EPICES score was higher in the migrant group (52.8 vs. 28.3, p < 0.05), HbA1c was also higher in the migrant group (8.4 vs. 6.7% (68 vs. 50 mmol/mol)).
CONCLUSIONS
We may fear that migrants share an increased risk of uncontrolled diabetes. Individual migration could be a risk factor of uncontrolled diabetes. Knowing the migration history of migrant patients is fundamental to understand some barriers of care.
目的
探讨移民及相关参数对糖尿病控制的影响。
方法
在法国国家保险系统下属的一个位于有大量移民现象地区的中心，招募一组2型糖尿病移民患者。患者填写了一份关于糖尿病、移民史和EPICES评分（贫困评分）的问卷。我们通过单因素和多因素分析探究移民的任何特征是否与糖尿病控制有关。将该队列与年龄和性别匹配的非移民对照组进行比较。
结果
我们纳入了72名患者，其中36名女性和36名男性，来自20个不同国家。平均年龄为57.7±9.6岁。家庭团聚移民与更好的糖尿病平衡相关（糖化血红蛋白水平≥8%（63.9 mmol/mol）的风险：比值比0.07（95%置信区间[0.005 - 0.86]，p = 0.04）。希望在退休期间在法国和原籍国两地生活的移民患者血糖控制优于只想独自回国的移民患者（比值比0.08[0.01 - 0.78]，p = 0.03）。与非移民组相比，移民组的EPICES评分更高（52.8对28.3，p < 0.05），移民组的糖化血红蛋白水平也更高（8.4%对6.7%（68对50 mmol/mol））。
结论
我们可能担心移民患糖尿病控制不佳的风险增加。个人移民可能是糖尿病控制不佳的一个风险因素。了解移民患者的移民史对于理解一些护理障碍至关重要。
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