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

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

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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • African Continental Ancestry Group / statistics & numerical data*
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Cameroon / epidemiology
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetic Nephropathies / blood
  • Diabetic Nephropathies / epidemiology
  • Diabetic Retinopathy / blood
  • Diabetic Retinopathy / epidemiology
  • Emigrants and Immigrants / statistics & numerical data*
  • European Continental Ancestry Group / statistics & numerical data*
  • Female
  • France / epidemiology
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Hypertension / epidemiology*
  • Life Style
  • Male
  • Middle Aged
  • Prevalence
  • Quality of Health Care

Substances

  • Biomarkers
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human