The diabetic immigrant: cardiovascular risk factors and control. Contributions of the IDIME study

The aim of this study was to determine the clinical characteristics of diabetes and associated cardiovascular risk factors in immigrants with diabetes in Spain.

A multicenter, observational, cross-sectional study including a cohort of 605 diabetic immigrants and 307 native diabetics was conducted in patients diagnosed with diabetes and treated in primary and specialized care in Spain. A consecutive sampling method was followed. We studied epidemiological, clinical and laboratory variables related to diabetes and the presence of classical risk factors.

The immigrant diabetic patient was younger (50.4 [11.5] vs 62.7 [13] years) and had fewer years of diabetes progression (5.8 [6.4] vs 10.5 [8.3] years) (P<.001) compared with native diabetic patients. Immigrants from South America with diabetes were more obese. No statistically significant differences were found in abdominal obesity or the waist/height ratio. Glycemic control was worse in immigrants than in the native Spaniard group (glycosylated hemoglobin, 7.8 [2.2] vs 7.1 [1.5%]), especially among South Asians (8.1[2.5%]) (P<.001), in whom insulin use was lower (12.8% vs 30.7% in other immigrants) (P<.001). However, the prevalence of chronic complications of diabetes was lower among immigrants, particularly that of macrovascular complications (7.7% vs 24.4%) (P<.01).

In our study the profile of immigrant diabetics in Spain is one of a young diabetic without complications, but with worse metabolic control. These findings provide an excellent opportunity to implement preventive measures.