Problems of diabetes management in the immigrant population in Germany

Abstract 

Aim

To compare prospectively the effect of diabetes management in the immigrant and the native population in Berlin, Germany.

Methods

Diabetes patients attending a metabolic outpatient clinic in an area with a high immigrant population were studied at the start of the training program and after 12 months of participation.

Results

1607 of 2099 patients with at least one post-training visit (76.6%) provided analysable data. Of these 362 (22.5%) were immigrants. Initial hemoglobinA_1c (HbA_1c) was higher in the immigrants. Immigrants were 5 years younger and had a more recent diagnosis of diabetes. HbA_1c fell by 1.4 and 1.5 percentage points in the immigrants and natives, leaving a greater proportion of the immigrants above the target value of 6.5%. Analysis of patients matched according to baseline HbA_1c, sex and age showed a smaller decrease in mean HbA_1c for the immigrants. The percent of patients with hypertension, obesity, dyslipidaemia or diabetic complications was comparable in both groups initially and after 12 months.

Conclusion

Immigrants had a higher HbA_1c concentration at baseline and after 12 months compared to natives, despite a similar decline in HbA_1c percentage points. More investigations are warranted to identify the causes, such as dietary habits, language difficulties, education and others.

Keywords: Diabetes type 2, Immigrant community, Therapy, HbA_1c, Hypertension