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 and Silvano Gabriele Cella
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Gianfrancesco Fiorini: Department of Clinical Sciences and Community Health, University of Milan, 20136 Milan, Italy
Ivan Cortinovis: Department of Clinical Sciences and Community Health, University of Milan, 20136 Milan, Italy
Giovanni Corrao: National Centre for Healthcare Research and Pharmacoepidemiology, 20126 Milan, Italy
Matteo Franchi: National Centre for Healthcare Research and Pharmacoepidemiology, 20126 Milan, Italy
Angela Ida Pincelli: Endocrinology and Diabetology Unit, San Gerardo Hospital, 20900 Monza, Italy
Mario Perotti: Endocrinology and Diabetology Unit, San Gerardo Hospital, 20900 Monza, Italy
Antonello Emilio Rigamonti: Department of Clinical Sciences and Community Health, University of Milan, 20136 Milan, Italy
Alessandro Sartorio: Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Verbania, Italy
Silvano Gabriele Cella: Department of Clinical Sciences and Community Health, University of Milan, 20136 Milan, Italy

IJERPH, 2020, vol. 17, issue 21, 1-15

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.

Keywords: type 2 diabetes; pharmacological treatment; undocumented migrants; diabetes phenotypes; ethnicity; complications of diabetes (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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