Istituti Clinici Zucchi, Gruppo San Donato, Carate Brianza, Italy.
Department of Clinical Sciences and Community Health, University of Milan, Italy.
Prim Care Diabetes. 2020 Feb;14(1):21-28. doi: 10.1016/j.pcd.2019.04.004. Epub 2019 May 4.
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.
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.
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.
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.
来自卫生和社会条件不尽如人意的国家的移民及其后代，正在成为西方人口的一个不断增长的组成部分。现有健康数据表明，他们的发病率至少与东道国人口相当，其中糖尿病等慢性病的发病率显著。未登记移民中糖尿病表现出不同特征的可能性，是我们在这项研究中试图调查的假设。
我们回顾性分析了 413 例 2 型糖尿病（T2DM）患者的数据：222 例在大学医院的糖尿病诊所接受随访，191 例未登记移民由意大利米兰的一家慈善机构照顾。
我们发现移民的发病年龄更早；他们的体重指数（BMI）明显较低，社会经济条件较差。他们的血糖控制较差。两组患者的并发症模式也不同，意大利人更常发生心血管并发症。最后，药物治疗也有显著差异。
未登记移民和本地人 T2DM 的发病年龄、临床表现和并发症可能存在显著差异。这具有重要的流行病学和临床意义。如果这些初步观察结果得到更大规模研究的证实，我们可以得出结论，未登记移民应比本地人更早筛查 T2DM，治疗应根据其疾病的具体特征进行调整。
