Pharmacological Treatment of Type-2-Diabetes and Cardiovascular Comorbidities: Differences between Undocumented Migrants and Natives in Italy.
Gianfrancesco FioriniGiacomo PellegriniMatteo FranchiAngela Ida PincelliAntonello Emilio RigamontiGiovanni CorraoAlessandro SartorioSilvano Gabriele CellaPublished in: Healthcare (Basel, Switzerland) (2022)
Diabetes prevalence is growing worldwide, especially in some populations. Though migrations seem to contribute to the presence in host countries of a significant number of patients with diabetes and its comorbidities, very little is known about the health conditions of undocumented migrants. We retrospectively studied 838 patients with type 2 diabetes mellitus (T2DM), 425 Italians followed by the diabetes clinic of a university hospital, and 413 undocumented migrants receiving assistance from a non-governmental organization. We analyzed their demographic and clinical data together with the medications they were on. The prevalence of the use of specific classes of drugs was compared between undocumented migrants and Italians by fitting a Poisson regression model, and the results were reported as prevalence rate ratios (PRRs) with a 95% confidence interval. Undocumented migrants with T2DM received fewer medications for cardiovascular (CV) conditions (PRR: 0.68, 0.60 to 0.76) than Italians, after correcting for confounding factors. Only sulfonylureas were more frequently used in undocumented migrants. The causes of these differences are not completely clear, but social, cultural, and economic factors can have an important role. More efforts are needed to provide appropriate treatment of diabetes and its CV comorbidities to undocumented migrants.
Keyphrases
- type diabetes
- glycemic control
- cardiovascular disease
- risk factors
- healthcare
- mental health
- end stage renal disease
- primary care
- newly diagnosed
- ejection fraction
- metabolic syndrome
- risk assessment
- weight loss
- skeletal muscle
- health information
- electronic health record
- patient reported outcomes
- social media
- artificial intelligence
- adipose tissue
- replacement therapy
- human health