Type 2 diabetes prevalence, health status and quality of care among the North African immigrant population living in France.
OBJECTIVE
This report is an overview of type 2 diabetes (DT2) in the North African immigrant population living in France.


METHODS
Data were collected in two separate cross-sectional national surveys. DT2 prevalence was estimated using a population-based survey involving 13 959 people aged ≥ 45 years (EDS), while health status and quality of care were evaluated using a sample of 3894 DT2 patients (ENTRED).


RESULTS
Prevalence of DT2 and obesity was 14.0% [CI 95%: 9.9; 18.0] and 20.5% [15.7; 25.3], respectively, in participants born in North Africa (BNA) and 7.5% [7.0; 8.0] and 15.8% [14.7; 16.8], respectively, in those born in France (BIF). DT2 was associated with region of birth in women after adjusting for age, body mass index and income or occupation, but not after adjusting for education level. In men, DT2 was not associated with region of birth. BNA and BIF patients with diabetes frequently benefited from free medical coverage (88% vs. 84%, respectively), although BNA diabetic patients visited a general practitioner less frequently than BIF (8.5 vs. 9.0 visits/year, respectively). The percentage of BNA vs. BIF diabetes patients tested three times a year for HbA1c was lower (39% vs. 44%), while HbA1c was higher in BNA vs. BIF diabetics (> 8%: 30% vs. 15%). Ophthalmological complications were also more frequent in BNA vs. BIF patients with diabetes (25% vs. 18%, respectively).


CONCLUSIONS
The greater prevalence of DT2 in BNA women and the poorer glycaemic control observed in the BNA population overall both probably contribute to disparity in diabetes mortality compared with BIF diabetics, a fact that has been observed in previous studies.
Department of Chronic Diseases and Injuries, French Institute for Public Health Surveillance, 12, rue du Val-d'Osne, 94415 Saint-Maurice cedex, France. Electronic address: s.fosse@invs.sante.fr.
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Fosse-Edorh
Department of Chronic Diseases and Injuries, French Institute for Public Health Surveillance, 12, rue du Val-d'Osne, 94415 Saint-Maurice cedex, France; Strategy and Research Department, National Health Insurance, Île-de-France, Paris, France.
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Fagot-Campagna
Cemka-Eval, Bourg-la-Reine, France.
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Detournay
Department of Endocrinology, Diabetology and Metabolic Disease, Avicenne Hospital, Paris XIII University and Assistance Publique-Hôpitaux de Paris, Bobigny, France.
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Bihan
National Institute for Prevention and Health Education, Saint-Denis, France.
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Gautier
Department of Chronic Diseases and Injuries, French Institute for Public Health Surveillance, 12, rue du Val-d'Osne, 94415 Saint-Maurice cedex, France.
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Dalichampt
Department of Chronic Diseases and Injuries, French Institute for Public Health Surveillance, 12, rue du Val-d'Osne, 94415 Saint-Maurice cedex, France.
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Druet
D000328:Adult; D017677:Age Distribution; D044383:Black People / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000208:ethnology; D004522:Educational Status; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000208:ethnology; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data; D015995:Prevalence; D011787:Quality of Health Care; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016903:Drug Monitoring
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
Health status; Immigrant; Prevalence; Quality of care; Type 2 diabetes