PMID- 25884923 OWN - NLM STAT- MEDLINE DCOM- 20151117 LR - 20221207 IS - 1471-2458 (Electronic) IS - 1471-2458 (Linking) VI - 15 DP - 2015 Feb 6 TI - Differences in diabetes prevalence and inequalities in disease management and glycaemic control by immigrant status: a population-based study (Italy). PG - 87 LID - 10.1186/s12889-015-1403-4 [doi] LID - 87 AB - BACKGROUND: The diabetes prevalence increases at an alarming rate around the world and understanding disparities in occurrence, care management, and health outcomes may be a starting point towards achieving more effective strategies to prevent and manage it. The aims of this study are to compare immigrants and Italians in terms of the differences in diabetes prevalence and to evaluate inequalities in disease management and glycaemic control by using information included in Reggio Emilia diabetes register. METHODS: We retrieved from the diabetes register subjects aged 20-74 on December 31(st), 2009. Using citizenship, we created three main groups: Italy, High Developed Countries (HDC), and High Migration Pressure Countries (HMPC). These were split into sub-regions of origin. We calculated age-adjusted prevalence by gender and sub-region. Using logistic regression model, we analyzed the association between area of origin and following indicators: 1) not being in care of diabetes clinics; 2) not having glycated haemoglobin (HbA1c) test in 2010; 3) among those tested, having a HbA1c value > = 9% (75 mmol/mol). RESULTS: We found 15,889 Italian and 1,295 HMPC citizens with diabetes. HMPC citizens had higher age-adjusted prevalence of diabetes than Italians (females 5.0% vs 3.6%; males 6.5% vs 5.5%). The excess was mostly due to a strong excess in immigrants from Southern Asia (females 9.7%, males 10.2%) and Northern Africa (females 9.3%, males 5.9%). HMPC citizens were cared for by diabetes clinics in a similar proportion than Italians (OR: 1.08; 95% CI: 0.93-1.25), but had a greater odds of not being tested for HbA1c (OR: 1.51; 95% CI: 1.34-1.71), as well as of having HbA1c values equal to or over 9% (OR: 2.06; 95% CI: 1.80-3.14). The outcomes were poorer in HMPC females for the first two outcomes, while there was no difference for the HbA1c values (Wald test for heterogeneity p = 0.0850; p = 0.0156; p = 0.6635, respectively). CONCLUSIONS: Our findings highlight the need for gender-oriented actions for prevention and early diagnosis of the diabetes to contrast the higher risk in Northern Africans and Southern Asians. Further studies are required to determine whether the protocols in use are adequate for different immigrant groups. FAU - Ballotari, Paola AU - Ballotari P AD - Servizio Interaziendale di Epidemiologia, Local Health Authority, Via Amendola 2, Reggio Emilia, Italy. paola.ballotari@ausl.re.it. AD - IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. paola.ballotari@ausl.re.it. FAU - Caroli, Stefania AU - Caroli S AD - Servizio Interaziendale di Epidemiologia, Local Health Authority, Via Amendola 2, Reggio Emilia, Italy. stefania.caroli@ausl.re.it. AD - IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. stefania.caroli@ausl.re.it. FAU - Ferrari, Francesca AU - Ferrari F AD - Servizio Interaziendale di Epidemiologia, Local Health Authority, Via Amendola 2, Reggio Emilia, Italy. francy.ferr80@gmail.com. AD - IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. francy.ferr80@gmail.com. FAU - Romani, Gabriele AU - Romani G AD - IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. gabriele.romani@ausl.re.it. FAU - Marina, Greci AU - Marina G AD - Primary Health Care, Local Health Authority, Reggio Emilia, Italy. marina.greci@ausl.re.it. FAU - Chiarenza, Antonio AU - Chiarenza A AD - Research and Innovation Unit, Local Health Authority, Reggio Emilia, Italy. antonio.chiarenza@ausl.re.it. FAU - Manicardi, Valeria AU - Manicardi V AD - Department of Internal Medicine, Hospital of Montecchio, Local Health Authority, Reggio Emilia, Italy. valeria.manicardi@ausl.re.it. FAU - Giorgi Rossi, Paolo AU - Giorgi Rossi P AD - Servizio Interaziendale di Epidemiologia, Local Health Authority, Via Amendola 2, Reggio Emilia, Italy. paolo.giorgirossi@ausl.re.it. AD - IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. paolo.giorgirossi@ausl.re.it. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20150206 PL - England TA - BMC Public Health JT - BMC public health JID - 100968562 RN - 0 (Blood Glucose) RN - 0 (Glycated Hemoglobin A) SB - IM MH - Adult MH - Africa, Northern/ethnology MH - Age Factors MH - Aged MH - Asia/ethnology MH - Blood Glucose MH - Diabetes Mellitus/*ethnology/*therapy MH - *Disease Management MH - Emigrants and Immigrants/*statistics & numerical data MH - Female MH - Glycated Hemoglobin/analysis MH - Health Services Needs and Demand MH - Humans MH - Italy/epidemiology MH - Logistic Models MH - Male MH - Middle Aged MH - Prevalence MH - Sex Factors PMC - PMC4334763 EDAT- 2015/04/18 06:00 MHDA- 2015/11/18 06:00 PMCR- 2015/02/06 CRDT- 2015/04/18 06:00 PHST- 2014/05/15 00:00 [received] PHST- 2015/01/12 00:00 [accepted] PHST- 2015/04/18 06:00 [entrez] PHST- 2015/04/18 06:00 [pubmed] PHST- 2015/11/18 06:00 [medline] PHST- 2015/02/06 00:00 [pmc-release] AID - 10.1186/s12889-015-1403-4 [pii] AID - 1403 [pii] AID - 10.1186/s12889-015-1403-4 [doi] PST - epublish SO - BMC Public Health. 2015 Feb 6;15:87. doi: 10.1186/s12889-015-1403-4.