Health, health care utilization and living conditions in foreign-born diabetic patients in southern Sweden.
OBJECTIVE
To compare foreign- and Swedish-born diabetic subjects regarding health care utilization, complications, clinical and socio-economic characteristics.


METHODS
Cross-sectional study.


METHODS
All known diabetic patients living in six defined primary health care districts.


METHODS
Of 1861 identified subjects aged > 25 years 90.1%. 113 foreign- and 1564 Swedish-born subjects participated. Mean time of residence in Sweden was 32 +/- 1.2 years, 93% > 10 years.


METHODS
A standardized interview, a physical examination and an evaluation of medical records.


RESULTS
No differences were found regarding living conditions or health care utilization, with the exception of higher use of home-care from public authorities in Swedish-born subjects (P < 0.05) despite no difference in dependency on help according to Katz's ADL index. There were no major differences in objective health (glycaemic control and complications related to diabetes) with the exception of lower frequency of sensory neuropathy (P < 0.01) and peripheral vascular disease (P < 0.05) in foreign-born subjects. The prevalence of diabetes was 2.1% (95% CI 1.7-2.5) in the foreign-born and 2.6% (95% CI 2.5-2.7) in Swedes. Foreign-born individuals were five years younger (P < 0.001), were more often diagnosed > or = 30 years (P < 0.05), had a two years' shorter duration of disease (P < 0.001) and were less often treated with insulin (P < 0.01). Treatment with insulin was related to the duration and presence of complications related to diabetes.


CONCLUSIONS
There were no major differences in objective health or use of health care in European migrants with diabetes mellitus, mainly Scandinavians, with short cultural distance and long residence in Sweden compared to Swedish-born diabetic patients.
Hjelm
K
K
Department of Community Health Sciences Dalby/Lund, University of Lund, Sweden.
Apelqvist
J
J
Nyberg
P
P
Sundquist
J
J
Isacsson
A
A
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D003920:Diabetes Mellitus; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D013548:Sweden