Pharmacological Treatment of Type-2-Diabetes and Cardiovascular Comorbidities: Differences between Undocumented Migrants and Natives in Italy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Medicine
2.3. Statistical Analysis
3. Results
3.1. Antidiabetic Drugs
3.2. Cardiovascular Drugs
3.3. Sensitivity Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Total Subjects | Undocumented Migrants | Italians | Missing Data | p-Value |
---|---|---|---|---|---|
n = 838 | n = 413 | n = 425 | |||
Age in years, median (IQR) | 60.0 (15) | 54 (15) | 65 (14) | <0.0001 | |
<50 | 160 (19.1) | 138 (33.4) | 22 (8.2) | <0.0001 | |
50–59 | 245 (29.2) | 155 (37.5) | 90 (21.2) | ||
60–69 | 246 (29.1) | 85 (20.6) | 161 (37.9) | ||
≥70 | 187 (22.3) | 35 (8.5) | 152 (35.8) | ||
Age at diagnosis, median (IQR) | 49 (15) | 45 (15) | 52 (14) | 72 | <0.0001 |
Female | 334 (39.9) | 171 (41.4) | 163 (38.4) | 0.3671 | |
Nationality, n (%) | - | ||||
Italian | 425 (51.2) | - | 425 (100.0) | ||
Eastern Europe | 95 (11.5) | 95 (23.5) | - | ||
Mediterranean Africa | 63 (8.6) | 63 (15.6) | - | ||
Sub-Saharan Africa | 37 (4.5) | 37 (9.2) | - | ||
Central Asia | 1 (0.1) | 1 (0.3) | - | ||
South Asia | 80 (9.6) | 80 (19.8) | - | ||
East Asia | 28 (3.4) | 28 (6.9) | - | ||
Latin America | 101 (12.2) | 101 (24.9) | - | ||
BMI, mean (SD) | 29.4 (6.4) | 28.6 (6.9) | 30.2 (5.9) | 30 | 0.0003 |
Familiarity for diabetes | 509 (65.3) | 181 (43.8) | 328 (77.2) | 58 | <0.0001 |
Cardiovascular disease risk factors | 731 (88.0) | 329 (79.7) | 402 (94.6) | 7 | <0.0001 |
Risk behaviors | 253 (30.2) | 114 (27.6) | 139 (32.7) | 142 | <0.0001 |
Hospitalization for diabetes | 141 (17.0) | 129 (31.2) | 12 (2.8) | 7 | <0.0001 |
HbA1C, mean (SD) | 7.8 (1.8) | 8.6 (2.1) | 7.2 (1.1) | 66 | <0.0001 |
Glycosuria | 238 (31.8) | 148 (35.8) | 90 (21.2) | 90 | <0.0001 |
Ketonuria | 18 (2.3) | 14 (3.4) | 4 (0.9) | 96 | 0.0030 |
Cardiovascular disease | 195 (23.3) | 79 (19.1) | 116 (27.3) | 2 | 0.0058 |
Diabetic nephropathy | 131 (16.3) | 80 (19.4) | 51 (12.4) | 34 | 0.0025 |
Diabetic retinopathy | 166 (21.2) | 79 (19.1) | 87 (20.5) | 54 | 0.7353 |
Diabetic neuropathy | 82 (11.6) | 29 (7.0) | 53 (17.2) | 129 | <0.0001 |
Ulcers | 50 (6.1) | 41 (9.9) | 9 (2.1) | 15 | <0.0001 |
Q-score, mean (SD) | 23.3 | 22.2 (9.3) | 24.4 (8.6) | 0.0005 |
Type of Drug | ATC Code | Total Subjects | Undocumented Migrants | Italians | p-Value |
---|---|---|---|---|---|
n = 838 | n = 413 | n = 425 | |||
Any oral diabetes medications | 643 (76.9) | 299 (72.6) | 344 (81.1) | 0.0033 | |
Insulins and analogues for injection, fast-acting | A10AB | 216 (25.8) | 111 (26.9) | 105 (24.8) | 0.4850 |
Insulins and analogues for injection, intermediate- or long-acting combined with fast-acting | A10AE, A10AD | 344 (41.1) | 139 (33.7) | 205 (48.4) | <0.0001 |
Metformin | A10BA02 | 581 (69.3) | 263 (63.7) | 318 (74.8) | 0.0005 |
Sulfonylureas | A10BB, A10BC, A10BD01, A10BD02, A10BD04, A10BD06 | 143 (17.1) | 85 (20.6) | 58 (13.7) | 0.0076 |
Glinides | A10BX02, A10BX03, A10BX08, A10BD14 | 13 (1.6) | 2 (0.5) | 11 (2.6) | 0.0137 |
Alpha glucosidase inhibitors | A10BF | 16 (1.9) | 6 (1.5) | 10 (2.4) | 0.3411 |
Thiazolidinediones | A10BG | 11 (1.3) | 3 (0.7) | 8 (1.9) | 0.1416 |
Dipeptidyl peptidase 4 (DPP-4) inhibitors | A10BH, A10BD07, A10BD08; A10BD10, A10BD11, A10BD13, A10BD18 | 96 (11.5) | 54 (13.1) | 42 (9.9) | 0.1468 |
Glucagon-like peptide-1 (GLP-1) analogues | A10BJ, A10BX04, A10BX07, A10BX10, A10BX13, A10BX14 | 59 (7.0) | 0 (0.0) | 59 (13.9) | <0.0001 |
Sodium–glucose co-transporter 2 (SGLT2) inhibitors | A10BK, A10BX09, A10BX11, A10BX12, A10BD15, A10BD16, A10BD20 | 52 (6.2) | 7 (1.7) | 45 (10.6) | <0.0001 |
Other blood glucose-lowering drugs, excl. insulins | A10BX | 31 (3.7) | 16 (3.9) | 15 (3.5) | 0.7916 |
Disease | ATC Code | Total Subjects | Undocumented Migrants | Italians | p-Value |
---|---|---|---|---|---|
n = 838 | n = 413 | n = 425 | |||
Any heart and vessels disease drugs | C01, C02, C03, C05, C07, C08, C09, B01 | 564 (67.3) | 210 (50.9) | 354 (83.3) | <0.0001 |
Cardiac therapy | C01 | 53 (6.3) | 17 (4.1) | 36 (8.5) | 0.0096 |
Antihypertensives | C02 | 35 (4.2) | 3 (0.8) | 32 (7.5) | <0.0001 |
Diuretics | C03 | 136 (16.2) | 30 (7.3) | 106 (24.9) | <0.0001 |
Vasoprotectives | C05 | 0 | - | - | - |
Beta blockers | C07 | 205 (24.5) | 69 (16.7) | 136 (32.0) | <0.0001 |
Calcium channel blockers | C08 | 198 (23.6) | 80 (19.4) | 118 (27.8) | 0.0042 |
Renin–angiotensin system (RAS)-acting agents | C09 | 440 (52.5) | 166 (40.2) | 274 (64.5) | <0.0001 |
ACE inhibitors | C09A, C09B | 234 (27.9) | 85 (20.6) | 149 (35.1) | <0.0001 |
ARBs | C09C, C09D | 212 (25.3) | 84 (20.3) | 128 (30.1) | 0.0011 |
Antithrombotics | B01 | 271 (32.3) | 73 (17.7) | 198 (46.6) | <0.0001 |
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Fiorini, G.; Pellegrini, G.; Franchi, M.; Pincelli, A.I.; Rigamonti, A.E.; Corrao, G.; Sartorio, A.; Cella, S.G. Pharmacological Treatment of Type-2-Diabetes and Cardiovascular Comorbidities: Differences between Undocumented Migrants and Natives in Italy. Healthcare 2023, 11, 4. https://doi.org/10.3390/healthcare11010004
Fiorini G, Pellegrini G, Franchi M, Pincelli AI, Rigamonti AE, Corrao G, Sartorio A, Cella SG. Pharmacological Treatment of Type-2-Diabetes and Cardiovascular Comorbidities: Differences between Undocumented Migrants and Natives in Italy. Healthcare. 2023; 11(1):4. https://doi.org/10.3390/healthcare11010004
Chicago/Turabian StyleFiorini, Gianfrancesco, Giacomo Pellegrini, Matteo Franchi, Angela Ida Pincelli, Antonello Emilio Rigamonti, Giovanni Corrao, Alessandro Sartorio, and Silvano Gabriele Cella. 2023. "Pharmacological Treatment of Type-2-Diabetes and Cardiovascular Comorbidities: Differences between Undocumented Migrants and Natives in Italy" Healthcare 11, no. 1: 4. https://doi.org/10.3390/healthcare11010004