TY - JOUR KW - Adult KW - Female KW - Humans KW - Aged KW - Male KW - Middle Aged KW - Cross-Sectional Studies KW - Prevalence KW - Aged, 80 and over KW - Quality of Health Care KW - African Continental Ancestry Group/ statistics & numerical data KW - Biological Markers/blood KW - Cameroon/epidemiology KW - Diabetes Mellitus, Type 2/blood/ epidemiology/ethnology KW - Diabetic Nephropathies/blood/epidemiology KW - Diabetic Retinopathy/blood/epidemiology KW - Emigrants and Immigrants/ statistics & numerical data KW - European Continental Ancestry Group/ statistics & numerical data KW - France/epidemiology KW - Hemoglobin A, Glycosylated/metabolism KW - Hypertension/ epidemiology KW - Life Style AU - Kengne A. AU - Sobngwi E. AU - Mbanya J. AU - Kaze F. AU - Choukem S. AU - Fabreguettes C. AU - Akwo E. AU - Porcher R. AU - Nguewa J. AU - Bouche C. AU - Vexiau P. AU - Gautier J. AB -

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.

AD - Department of Diabetes and Endocrinology, Hopital Lariboisiere, Assistance Publique-Hopitaux de Paris, University Paris-Diderot Paris-7, Paris, France; Department of Clinical Sciences, Faculty of Health Sciences, University of Buea, Buea, Cameroon. Electronic address: schoukem@gmail.com.
Department of Diabetes and Endocrinology, Hopital Lariboisiere, Assistance Publique-Hopitaux de Paris, University Paris-Diderot Paris-7, Paris, France.
National Obesity Centre, Yaounde Central Hospital, Yaounde, Cameroon.
Department of Biostatistics and Medical Computing, Saint-Louis University Hospital, Assistance Publique-Hopitaux de Paris, University Paris-Diderot Paris-7, Paris, France.
Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde-1, Yaounde, Cameroon.
South African Medical Research Council and University of Cape Town, Cape Town, South Africa; The George Institute for International Health, the University of Sydney, Sydney, Australia.
National Obesity Centre, Yaounde Central Hospital, Yaounde, Cameroon; Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde-1, Yaounde, Cameroon.
Department of Diabetes and Endocrinology, Hopital Lariboisiere, Assistance Publique-Hopitaux de Paris, University Paris-Diderot Paris-7, Paris, France; INSERM U872, Cordeliers Institute of Biomedical Research, Paris-6 University, Paris, France. Electronic address: jean-francois.gautier@sls.aphp.fr. AN - 24076360 BT - Diabetes and Metabolism DP - NLM ET - 2013/10/01 LA - eng LB - PDO M1 - 1 N1 - Choukem, S P
Fabreguettes, C
Akwo, E
Porcher, R
Nguewa, J L
Bouche, C
Kaze, F F
Kengne, A P
Vexiau, P
Mbanya, J C
Sobngwi, E
Gautier, J-F
Comparative Study
Research Support, Non-U.S. Gov't
France
Diabetes Metab. 2014 Feb;40(1):56-60. doi: 10.1016/j.diabet.2013.07.004. Epub 2013 Sep 26. N2 -

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.

PY - 2014 SN - 1878-1780 (Electronic)
1262-3636 (Linking) SP - 56 EP - 60 T2 - Diabetes and Metabolism TI - Influence of migration on characteristics of type 2 diabetes in sub-Saharan Africans VL - 40 ER -