Current pharmacological treatment of type 2 diabetes mellitus in undocumented migrants: Is it appropriate for the phenotype of the disease?

Gianfrancesco Fiorini, Ivan Cortinovis, Giovanni Corrao, Matteo Franchi, Angela Ida Pincelli, Mario Perotti, Antonello Emilio Rigamonti, Alessandro Sartorio, Silvano Gabriele Cella

Research output: Contribution to journalArticlepeer-review

Abstract

Type 2 diabetes is increasingly recognized as a spectrum of metabolic disorders sharing chronic hyperglycaemia. In Europe, the continually growing number of migrants from developing countries could affect diabetes phenotypes. We evaluated a population of 426 Italians and 412 undocumented migrants. Using 17 variables (with the exclusion of ethnic origin) we performed a multiple component analysis to detect potential clusters, independently from ethnicity. We also compared the two groups to evaluate potential ethnicity associated differences. We found five clusters of patients with different disease phenotypes. Comparing Italians with undocumented migrants, we noted that the first had more often cardiovascular risk factors and neurologic involvement, while the latter had a higher frequency of diabetic ulcers and renal involvement. Metformin was used in a comparable percentage of patients in all clusters, but other antidiabetic treatments showed some differences. Italians were more often on insulin, due to a larger use of long acting insulin, and received a larger number of oral antidiabetics in combination. Pharmacological treatment of comorbidities showed some differences too. We suggest that type 2 diabetes should be considered as a spectrum of diseases with different phenotypes also in heterogeneous populations, and that this is not due only to ethnic differences.

Original languageEnglish
Article number8169
Pages (from-to)1-15
Number of pages15
JournalInternational Journal of Environmental Research and Public Health
Volume17
Issue number21
DOIs
Publication statusPublished - Nov 1 2020

Keywords

  • Complications of diabetes
  • Diabetes phenotypes
  • Ethnicity
  • Pharmacological treatment
  • Type 2 diabetes
  • Undocumented migrants

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

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