Diabete tipo 2 in una popolazione di immigrati a Roma: dati ...

epidemiologia.it

Diabete tipo 2 in una popolazione di immigrati a Roma: dati ...

Migrants visited at INMP ( 2009-2010)• Between 1 January 2009 and30 September 2010, 1034consecutive immigrants wereexamined, coming from 4continents:• Eastern Europe 36,7% ( 381patients)• Africa 28,5% ( 296 patients)• South America 19,3% ( 201patients)• Asia 15,5% ( 161 patients)


DISTRIBUZIONE GEOGRAFICA DEI PAZIENTI VISITATI


Migrants with type 2 diabetes• Among the patients examined, an overall prevalence of 8,8%(89/1034 patients) of type 2 diabetes was observed• The diagnosis concerned 62.6% of male patients and 37.4% of thefemales• Mean age of patients was 49,4 years ( +/- 13,7)• The geographic origin of diabetic patients was significantly differentthan the global population of subjects visited: we found a greaterpercentage of patients coming from :• Africa ( 43,8% versus 28,5%)• Asia ( 23,6% versus 15,5%)


Migration and diabetes studyAim of the study:• to analyze and compare possible inequalities in access to healthservices and in quality of care between Italians and migrants withtype 2 diabetesMethods:• Standardized questionnaires for two groups of patients:• Migrants with type 2 diabetes ( 150 patients)• Italians with type 2 diabetes ( 50 patients)


Questionnaires• Lifestyles and risk factors for diabetes in migrant andnon-migrant patients• Educational level and awareness of the disease• Doctor-patient relationship• Management of diabetes and adherence to the therapy


Italiani e immigrati con diabeteItalians Migrants P valueMean age 55,2±3,7 years 47,5±8,1 years P


Doctor-patient relationshipItalians Migrants P valueGood relationship with doctor 82,4% 46,2% P


GESTIONE DEL DIABETE E ADERENZA ALLA TERAPIAItalians Migrants P valueCheck blood sugar: always 76,5% 37,5% P


LIVELLO DI ISTRUZIONE E GESTIONE DEL DIABETEMigrants with diabetesLow level ofinstructionHigh level ofinstructionP valueCheck blood sugar: always 35.2% 42.5% NSAble to change eating plan:alwaysAble to take medication asprescribed: alwaysKeep appointment with doctor: always33.3% 42.9% NS34.1% 71.4% 0.00152.9% 75.0% 0.001


DIAGNOSI DI DIABETE NEGLI IMMIGRATIItaly Country of origin P valueDiabetes firstdiagnostic61.9% 38.1% P


Diabetes diagnosis• Most migrants were diagnosed with their type 2 diabetes well afterthey had migrated and settled in Italy• That often means a delayed diagnosis, with development ofcomplications which are in many cases present at the time thedisease is discovered, and a poorer management of the disease• That often means a delayed diagnosis, with development ofcomplications which are in many cases present at the time thedisease is discovered, and a poorer management of the disease


COMPLICANZE DEL DIABETE AL MOMENTO DELLA DIAGNOSIComplications ofdiabetes at the timeof diagnosisItalians Migrants P valueEyes 25,6%Cardiovascular 14,6%Limb 16,9%Neurological 7.2%Kidney 4.8%Eyes 26,3%Cardiovascular 21,2%Limb 19.8%Neurological 12.8%Kidney 7.3%P


Conclusions• Access to Health Services has improved for migrants, but it is stillnot on par with that for italians• There is a need of:• Cooperation between primary and secondary care• Training of health workers in cross-cultural medicine• Health education campaigns must also be carried out in schools andplaces where immigrants meet and must also include the distributionof multi-lingual information material• Multidisciplinary approach for diabetes, with the use of culturalmediators in health structures


• THANK YOU FOR YOUR ATTENTION!

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