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Diabetes Metab. 2014 Feb;40(1):56-60. doi: 10.1016/j.diabet.2013.07.004. Epub 2013 Sep 26.

Influence of migration on characteristics of type 2 diabetes in sub-Saharan Africans.

Author information

1
Department of Diabetes and Endocrinology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, University Paris-Diderot Paris-7, Paris, France; Department of Clinical Sciences, Faculty of Health Sciences, University of Buea, Buea, Cameroon. Electronic address: schoukem@gmail.com.
2
Department of Diabetes and Endocrinology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, University Paris-Diderot Paris-7, Paris, France.
3
National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon.
4
Department of Biostatistics and Medical Computing, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris, University Paris-Diderot Paris-7, Paris, France.
5
Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé-1, Yaoundé, Cameroon.
6
South African Medical Research Council and University of Cape Town, Cape Town, South Africa; The George Institute for International Health, the University of Sydney, Sydney, Australia.
7
National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon; Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé-1, Yaoundé, Cameroon.
8
Department of Diabetes and Endocrinology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, University Paris-Diderot Paris-7, Paris, France; INSERM U872, Cordeliers Institute of Biomedical Research, Paris-6 University, Paris, France. Electronic address: jean-francois.gautier@sls.aphp.fr.

Abstract

AIM:

This study compared the clinical and biochemical characteristics and microvascular complications found in three groups of type 2 diabetes (T2D) patients: Africans living in Africa; African immigrants living in France; and Caucasians living in France.

METHODS:

Diagnosed T2D Africans living in Cameroon (n=100) were compared with 98 African migrants diagnosed with T2D after having moved to France, and a group of 199 T2D Caucasian patients living in France. All underwent clinical and biochemical evaluations, and all were assessed for microvascular complications.

RESULTS:

The median duration of stay of the migrants in France was 15years before being diagnosed with diabetes. Despite similar durations of diagnosis, they were 8.9years younger at the time of diagnosis than Africans living in Cameroon (P<0.001). Caucasians and African immigrants in France had lower HbA1c values than Africans in Cameroon (P<0.001); they were also more aggressively treated for hypertension and dyslipidaemia and, therefore, had significantly lower blood pressure levels and better lipid profiles. Diabetic nephropathy and retinopathy rates were higher in Cameroon than in the two other groups. After adjusting for age, diabetes duration, HbA1c, hypertension and other covariates, only the prevalence of diabetic nephropathy (OR: 5.61, 95% CI: 2.32-13.53; P<0.0001) was higher in Cameroon compared with those living in France.

CONCLUSION:

Our results suggest that Africans who emigrate to France may develop diabetes earlier than those staying in their home country. However, the latter may be a reflection of late diagnosis of diabetes. Also, the less adequate diabetes and hypertension control in the latter would explain their higher rates of nephropathy. Large-scale cohorts are now warranted to substantiate these observations.

KEYWORDS:

Africans; Caucasians; Complications; Migration; Type 2 diabetes

PMID:
24076360
DOI:
10.1016/j.diabet.2013.07.004
[Indexed for MEDLINE]

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