Influence of migration on characteristics of type 2 diabetes in sub-Saharan Africans.
OBJECTIVE
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.


CONCLUSIONS
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.
Department of Diabetes and Endocrinology, Hôpital Lariboisière, Assistance Publique-Hôpitaux 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.
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Choukem
Department of Diabetes and Endocrinology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, University Paris-Diderot Paris-7, Paris, France.
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Fabreguettes
National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon.
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Akwo
Department of Biostatistics and Medical Computing, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris, University Paris-Diderot Paris-7, Paris, France.
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Porcher
Department of Diabetes and Endocrinology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, University Paris-Diderot Paris-7, Paris, France.
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Nguewa
Department of Diabetes and Endocrinology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, University Paris-Diderot Paris-7, Paris, France.
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Bouche
Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé-1, Yaoundé, Cameroon.
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Kaze
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.
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Kengne
Department of Diabetes and Endocrinology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, University Paris-Diderot Paris-7, Paris, France.
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Vexiau
National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon; Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé-1, Yaoundé, Cameroon.
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Mbanya
National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon; Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé-1, Yaoundé, Cameroon.
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Sobngwi
Department of Diabetes and Endocrinology, Hôpital Lariboisière, Assistance Publique-Hôpitaux 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.
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Gautier
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D044383:Black People / Q000706:statistics & numerical data*; D002163:Cameroon / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology* / Q000208:ethnology; D003928:Diabetic Nephropathies / Q000097:blood / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000097:blood / Q000453:epidemiology; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011787:Quality of Health Care; D044465:White People / Q000706:statistics & numerical data*
D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
Africans; Caucasians; Complications; Migration; Type 2 diabetes