title: High diabetes risk among asylum seekers in The Netherlands.
abstract: OBJECTIVE
  To map the prevalence and incidence of recorded diabetes among asylum seekers according to demographic factors and length of stay in the host country.
  
  
  METHODS
  We used a nationwide database from the Community Health Services for Asylum Seekers. The study population included all asylum seekers aged 20-79 years who arrived in the Netherlands between 2000 and 2008. Case allocation was based on International Classification of Primary Care codes. A general practice registry was used to obtain reference data. Standardized prevalence and incidence ratios were calculated and their association with length of stay was explored with Cox regression.
  
  
  RESULTS
  The study included 59 380 asylum seekers among whom there were 1227 recorded cases of diabetes. The prevalence of recorded diabetes was higher among asylum seekers compared with the reference population for both men (standardized prevalence ratio=1.85, 95% CI 1.71-1.91) and women (standardized prevalence ratio=2.26, 95% CI 2.08-2.45). The highest standardized prevalence ratios were found for asylum seekers from Somalia, Sudan and Sri Lanka. The standardized prevalence ratio was higher in asylum seekers aged ≥ 30 years. Incidence rates were higher compared with the reference population for all length-of-stay intervals.
  
  
  CONCLUSIONS
  Asylum seekers from the majority of countries of origin were at higher risk of diabetes compared with the general population in the Netherlands. Asylum seekers from Somalia were particularly at risk. This emerging public health issue requires attention from policy-makers and care providers.
authors.affiliation: Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam; Netherlands Association for Community Health Services, Utrecht.
authors.forename: S
authors.initials: S
authors.lastname: Goosen
authors.forename: B
authors.initials: B
authors.lastname: Middelkoop
authors.forename: K
authors.initials: K
authors.lastname: Stronks
authors.forename: C
authors.initials: C
authors.lastname: Agyemang
authors.forename: A E
authors.initials: AE
authors.lastname: Kunst
mesh_terms: D000328:Adult; D000346:Afghanistan / Q000208:ethnology; D000368:Aged; D003920:Diabetes Mellitus / Q000453:epidemiology*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007493:Iraq / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D016016:Proportional Hazards Models; D012036:Refugees / Q000706:statistics & numerical data*; D012042:Registries; D012306:Risk; D012998:Somalia / Q000208:ethnology; D013188:Sri Lanka / Q000208:ethnology; D013397:Sudan / Q000208:ethnology; D013997:Time Factors; D055815:Young Adult