Problems of diabetes management in the immigrant population in Germany
Received 29 August 2008; received in revised form 14 May 2009; accepted 14 July 2009. published online 26 October 2009.
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 hemoglobinA1c (HbA1c) was higher in the immigrants. Immigrants were 5 years younger and had a more recent diagnosis of diabetes. HbA1c 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 HbA1c, sex and age showed a smaller decrease in mean HbA1c 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 HbA1c concentration at baseline and after 12 months compared to natives, despite a similar decline in HbA1c percentage points. More investigations are warranted to identify the causes, such as dietary habits, language difficulties, education and others.
Interdisziplinäres Stoffwechsel-Centrum, Med. Klinik m. S. Hepatologie und Gastroenterologie, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
ABSTRACT