Skip to main content
SpringerLink
Log in

Ethnic differences in body composition, sociodemographic characteristics and lifestyle in people with type 2 diabetes mellitus living in Italy

  • Original Article
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

This study aimed to compare immigrants and Italian natives with type 2 diabetes mellitus (DM2) in terms of anthropometric parameters and lifestyle-related characteristics and to investigate the relationship between ethnicity and glycemic control in men and women with DM2 living in Italy. The sample included 100 immigrants (55 Albanians and 45 Africans) and 100 Italians, followed by the Public Health Clinics of Rimini. The association of ethnicity with sex, socioeconomic status, anthropometric and hematological characteristics, and lifestyle were examined. In addition, differences among groups in glycemic control were evaluated. Among males, African participants presented significantly lower values than other groups in adiposity parameters and triglycerides. The highest percentage of obesity and of normal weight was found in Italians and in Africans, respectively. Among females, there were scanty differences, but Italians presented higher WHR values than the other groups. No statistical differences appeared in hematological parameters among groups. There were no significant differences in glycemic control among groups and sexes. Also considering the differences between subjects with optimal (L) or nonoptimal (H) glycemic control, the differences in lifestyle, anthropometric, and hematological variables remained scarce. Among all groups, significantly higher values of glucose were detected in H than in L. A similar condition appeared for triglycerides in males. Immigrant and native Italian diabetics did not present any difference in their clinical characteristics, but Italians generally presented worst lifestyle habits. The percentage of subjects with poor metabolic control of diabetes was not low, but similar in immigrants and natives.

Highlights

  • There is a clear necessity to acquire knowledge of diabetes in immigrants through better data collection, especially in view of the scarcity of epidemiological studies evaluating the importance of this problem in EU countries.

  • The percentage of subjects with poor metabolic control of diabetes is high, and generally comparable between immigrants and natives.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Global Report on Diabetes (2018). http://www.who.int/diabetes/global-report/en/. Accessed 28 Mar 2018

  2. R. Testa, A.R. Bonfigli, S. Genovese, A. Ceriello, Focus on migrants with type 2 diabetes mellitus in European Countries. Intern. Emerg. Med. 11, 319–6 (2016)

    Article  PubMed  Google Scholar 

  3. Il diabete in Italia (2017). https://www.istat.it/it/archivio/202600. Accessed 26 Mar 2018

  4. Cittadini non comunitari: presenza, nuovi ingressi e acquisizioni di cittadinanza (2017). https://www.istat.it/it/archivio/204296. Accessed 26 Mar 2018

  5. B.D. Gushulak, D.W. MacPherson, The basic principles of migration health: population mobility and gaps in disease prevalence. Emerg. Themes Epidemiol. 3, 3 (2016)

    Article  Google Scholar 

  6. P. Fine, C.G. Victora, K.J. Rothman et al. John Snow’s legacy: epidemiology without borders. Lancet 381, 1302–1311 (2013)

    Article  PubMed  PubMed Central  Google Scholar 

  7. G.M. Anderson, S.E. Bronskill, C.A. Mustard, A. Culyer, D.A. Alter, D.G. Manuel, Both clinical epidemiology and population health perspectives can define the role of healthcare in reducing health disparities. J. Clin. Epidemiol. 58, 757–762 (2005)

    Article  PubMed  Google Scholar 

  8. J.M. Robbins, V. Vaccarino, H. Zhang, S.V. Kasl, Socioeconomic status and type 2 diabetes in African American and non-Hispanic white women and men: evidence from the third national health and nutrition examination survey. Am. J. Public Health 91, 76–83 (2001)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. A.F. Brown, S.L. Ettner, J. Piette et al. Socioeconomic position and health among persons with diabetes mellitus: a conceptual framework and review of the literature. Epidemiol. Rev. 26, 63–77 (2004)

    Article  PubMed  Google Scholar 

  10. J.K. Ujcic-Voortman, M.T. Schram, M.A. Jacobs-van der Bruggen, A.P. Verhoeff, C.A. Baan, Diabetes prevalence and risk factors among ethnic minorities. Eur. J. Pub Health 19, 511–515 (2009)

    Article  Google Scholar 

  11. J.E. Shaw, R.A. Sicree, P.Z. Zimmet, Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res. Clin. Pract. 87, 4–14 (2010)

    Article  CAS  PubMed  Google Scholar 

  12. A.K. Jenum, L.M. Diep, G. Holmboe-Ottesen, M.K. HolmeI, B.N. Kumar, K.I. Birkeland, Diabetes susceptibility in ethnic minority groups from Turkey, Vietnam, Sri Lanka and Pakistan compared with Norwegians - the association with adiposity is strongest for ethnic minority women. BMC Public Health 12, 150 (2012)

    Article  PubMed  PubMed Central  Google Scholar 

  13. A. Adar, S. Shalitin, O. Eyal et al. Prevalence of early and late prematurity is similar among pediatric type 1 diabetes mellitus patients and the general population. Diabetes Metab. Res. Rev. 34, e2996 (2018)

    Article  CAS  PubMed  Google Scholar 

  14. C. Mohandas, R. Bonadonna, F. Shojee-Moradie et al. Ethnic differences in insulin secretory function between Black African and White European men with early type 2 diabetes. Diabetes Obes. Metab. 20, 1678–1687 (2018)

    Article  CAS  PubMed  Google Scholar 

  15. K.M. Narayan, J.P. Boyle, T.J. Thompson, S.W. Sorensen, D.F. Williamson, Lifetime risk for diabetes mellitus in the United States. JAMA 290, 1884–1890 (2003)

    Article  CAS  PubMed  Google Scholar 

  16. I. Shai, R. Jiang, J.E. Manson et al. Ethnicity, obesity, and risk of type 2 diabetes in women: a 20-year follow-up study. Diabetes Care. 29, 1585–1590 (2006)

    Article  PubMed  Google Scholar 

  17. P.L. Lutsey, M.A. Pereira, A.G. Bertoni, S. Wendy, Interactions between race/ethnicity and anthropometry in risk of incident diabetes: the multiethnic study of atherosclerosis. Am. J. Epidemiol. 172, 197–204 (2010)

    Article  PubMed  PubMed Central  Google Scholar 

  18. A. Ramachandran, R.C.W. Ma, C. Snehalatha, Diabetes in Asia. Lancet 375, 408–418 (2010)

    Article  PubMed  Google Scholar 

  19. E. Gualdi-Russo, L. Zaccagni, G.V. Dallari, S. Toselli, Anthropometric parameters in relation to glycaemic status and lipid profile in a multi-ethnic sample in Italy. Public Health Nutr. 18, 438–445 (2015)

    Article  PubMed  Google Scholar 

  20. E. Gualdi-Russo, N. Rinaldo, M. Khyatti, C. Lakhoua, S. Toselli, Weight status, fatness and body image perception of North African immigrant women in Italy. Public Health Nutr. 19, 2743–2751 (2016)

    Article  PubMed  Google Scholar 

  21. S. Toselli, E. Gualdi-Russo, D.N. Boulos et al. Prevalence of overweight and obesity in adults from North Africa. Eur. J. Public Health 24, 31–39 (2014)

    Article  PubMed  Google Scholar 

  22. V. Bos, A.E. Kunst, I.M. Keij-Deerenberg, J. Garssen, J.P. Mackenbach, Ethnic inequalities in age-and cause specific mortality in The Netherlands. Int J. Epidemiol. 33, 1112–1119 (2004)

    Article  PubMed  Google Scholar 

  23. M. Gadd, S.E. Johansson, J. Sundquist, P. Wandell, Are there differences in all-cause and coronary heart disease mortality between immigrants in Sweden and in their country of birth? A follow-up study of total populations. BMC Public Health 6, 102 (2006)

    Article  PubMed  PubMed Central  Google Scholar 

  24. J.V. Patel, A. Vyas, J.K. Cruickshank et al. Impact of migration on coronary heart disease risk factors: comparison of Gujaratis in Britain and their contemporaries in villages of origin in India. Atherosclerosis 185, 297–306 (2006)

    Article  CAS  PubMed  Google Scholar 

  25. S.L. Gomez, J.L. Kelsey, S.L. Glaser, M.M. Lee, S. Sidney, Immigration and acculturation in relation to health and health-related risk factors among specific Asian subgroups in a health maintenance organization. Am. J. Public Health 94, 1977–1984 (2004)

    Article  PubMed  PubMed Central  Google Scholar 

  26. A.F. Abraido-Lanza, M.T. Chao, K.R. Florez, Do healthy behaviors decline with greater acculturation? Implications for the Latino mortality paradox. Soc. Sci. Med. 61, 1243–1255 (2005)

    Article  PubMed  PubMed Central  Google Scholar 

  27. K. Hosper, V. Nierkens, M. Nicolaou, K. Stronks, Behavioural risk factors in two generations of non-Western migrants: do trends converge towards the host population? Eur. J. Epidemiol. 22, 163–172 (2007)

    Article  PubMed  PubMed Central  Google Scholar 

  28. B. Rechel, P. Mladovsky, D. Ingleby, J.P. Mackenbach, M. McKee, Migration and health in an increasingly diverse Europe. Lancet 381, 1235–1245 (2013)

    Article  PubMed  Google Scholar 

  29. ISTAT 2017. Cittadini non comunitari: presenza, nuovi ingressi e acquisizioni di cittadinanza (2017). https://www.istat.it/it/archivio/204296. Accessed 26 Mar 2018

  30. J. Franch-Nadal, M.C. Martínez-Sierra, A. Espelt, E. Sagarra-Busquets, F. Patitucci-Gómez, A. Goday-Arno, The diabetic immigrant: cardiovascular risk factors and control. Contributions of the IDIME study. Rev. Esp. Cardiol. 66, 39–46 (2013)

    Article  PubMed  Google Scholar 

  31. M.C. Bertolucci, A. Pimazoni-Netto, A.C. Pires et al. Diabetes and cardiovascular disease: from evidence to clinical practice - position statement 2014 of Brazilian Diabetes Society. Diabetol. Metab. Syndr. 6, 58 (2014)

    Article  Google Scholar 

  32. H.C. Gerstein, M.E. Miller, R.P. Byington, Action to control cardiovascular risk in Diabetes Study Group. Effects of intensive glucose lowering in type 2 diabetes. N. Engl. J. Med. 358, 2545–2559 (2008)

    Article  CAS  PubMed  Google Scholar 

  33. R.R. Holman, S.K. Paul, M.A. Bethel, D.R. Matthews, H.A. Neil, 10-year follow-up of intensive glucose control in type 2 diabetes. N. Engl. J. Med. 359, 1577–1589 (2008)

    Article  CAS  PubMed  Google Scholar 

  34. K.K. Ray, S.R. Seshasai, S. Wijesuriya et al. Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: a meta-analysis of randomised controlled trials. Lancet 373, 1765–1772 (2009)

    Article  CAS  PubMed  Google Scholar 

  35. Emerging Risk Factors Collaboration, N. Sarwar, P. Gao et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet 375, 2215–2222 (2010)

    Article  CAS  Google Scholar 

  36. M. Lind, I. Bounias, M. Olsson, S. Gudbjörnsdottir, A.M. Svensson, A. Rosengren, Glycaemic control and incidence of heart failure in 20.985 patients with type 1 diabetes: an observational study. Lancet 378, 140–146 (2011)

    Article  PubMed  Google Scholar 

  37. S. Rao Kondapally Seshasai, S. Kaptoge, A. Thompson et al. Diabetes mellitus, fasting glucose, and risk of cause-specific death. N. Engl. J. Med. 364, 829–841 (2011)

    Article  PubMed  PubMed Central  Google Scholar 

  38. M.I. Harris, R.C. Eastman, C.C. Cowie, K.M. Flegal, M.S. Eberhardt, Racial and ethnic differences in glycaemic control of adults with type 2 diabetes. Diabetes Care. 22, 40340–40348 (1999)

    Google Scholar 

  39. T.M. Davis, C.A. Cull, R.R. Holman, U.K. Prospective Diabetes, Study (UKPDS) Group. Relationship between ethnicity and glycemic control, lipid profiles, and blood pressure during the first 9 years of type 2 diabetes: U.K. Prospective Diabetes Study (UKPDS 55). Diabetes Care. 24, 1167–1174 (2001)

    Article  CAS  PubMed  Google Scholar 

  40. T. Fan, C.E. Koro, D.O. Fedder, S.J. Bowlin, Ethnic disparities and trends in glycemic control among adults with type 2 diabetes in the U.S. from 1988 to 2002. Diabetes Care. 29, 1924–1925 (2006)

    Article  PubMed  Google Scholar 

  41. L.C. Lanting, I.M.A. Joung, J.P. Mackenbach, S.W. Lamberts, A.H. Bootsma, Ethnic differences in mortality, end-stage complications, and quality of care among diabetic patients: a review. Diabetes Care. 28, 2280–2288 (2005)

    Article  PubMed  Google Scholar 

  42. P.H. Negandhi, N. Ghouri, H.M. Colhoun et al. Scottish Diabetes Research Network Epidemiology Group. Ethnic differences in glycaemic control in people with type 2 diabetes mellitus living in Scotland. PLoS ONE 8, e83292 (2013)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. A. Rawshani, A.M. Svensson, A. Rosengren, B. Zethelius, B. Eliasson, S. Gudbjörnsdottir, Impact of ethnicity on progress of glycemic control in 131,935 newly diagnosed patients with type 2 diabetes: a nationwide observational study from the Swedish National Diabetes Register. BMJ Open. 5, e007599 (2015)

    Article  PubMed  PubMed Central  Google Scholar 

  44. T.G. Lohman, A.F. Roche, R. Martorell, Anthropometric Standardization Reference Manual (Human Kinetics Books, Champaign, 1988).

  45. World Health Organization, Waist circumference and waist–hip ratio. Report of a WHO Expert Consultation (WHO, Geneva, 2008).

  46. Frisancho A. R., Anthropometric Standards: An Interactive Nutritional Reference of Body Size and Body Composition for Children and Adults, 2nd edn (University of Michigan Press, Michigan, MI, 2008)

  47. Scottish Intercollegiate Guidelines Network (SIGN) Management of diabetes (Healthcare Improvement Scotland, Edinburgh, 2010)

  48. P.E. Wändell, A. Wajngot, U. de Faire, M.L. Hellénius, Increased prevalence of diabetes among immigrants from non-European countries in 60-year-old men and women in Sweden. Diabetes Metab. 33, 30–36 (2007)

    Article  PubMed  Google Scholar 

  49. P. Zaninotto, J. Mindell, V. Hirani, Prevalence of cardiovascular risk factors among ethnic groups: results from the health surveys for England. Atherosclerosis 195, e48–e57 (2007)

    Article  CAS  PubMed  Google Scholar 

  50. P.E. Wändell, A. Carlsson, K.H. Steiner, Prevalence of diabetes among immigrants in the Nordic countries. Curr. Diabetes Rev. 6, 126e33 (2010)

    Article  Google Scholar 

  51. H. Vandenheede, P. Deboosere, A. Espelt et al. Educational inequalities in diabetes mortality across Europe in the 2000s: the interaction with gender. Int J. Public Health 60, 401–410 (2015)

    Article  PubMed  Google Scholar 

  52. I. Marzona, F. Avanzini, M. Tettamanti et al. Prevalence and management of diabetes in immigrants resident in the Lombardy Region: the importance of ethnicity and duration of stay. Acta Diabetol. 55, 355–362 (2018)

    Article  PubMed  Google Scholar 

  53. C. Agyemang, A.E. Kunst, R. Bhopal et al. Diabetes prevalence in populations of South Asian Indian and African origins: a comparison of England and the Netherlands. Epidemiology 22, 563e7 (2011)

    Article  Google Scholar 

  54. P.H. Negandhi, N. Ghouri, H.M. Colhoun et al. Ethnic differences in glycaemic control in people with type 2 diabetes mellitus living in Scotland. PLoS ONE 8, e83292 (2013)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. G. Papadakis, T. Zampelis, M. Michalopoulou, K. Konstantopoulos, T. Rosenberg, S. Chatzipanagiotou, Epidemiological and clinical study of diabetes in immigrants from Bangladesh in Athens versus Greek patients. Vivo 29, 223–227 (2015)

    CAS  Google Scholar 

Download references

Author contributions

All authors contributed to the preparation of the paper. S.T., F.C., and P.M. had the original idea for the trial and carried out the design with E.G.R. S.T. carried out the analysis reported in this paper, under the supervision of F.C. and E.G.R., and also prepared the initial draft of the paper. All authors critically reviewed the paper and approved the final version submitted for publication.

Author information

Authors and Affiliations

  1. Departments of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy

    Stefania Toselli & Francesco Campa

  2. Department of Biomedical Sciences and Surgical Specialties, University of Ferrara, Ferrara, Italy

    Emanuela Gualdi-Russo

  3. Unit of Internal Medicine, Diabetes and Metabolic Disease Center, Romagna Health District, Rimini, Italy

    Paolo Mazzuca

Authors
  1. Stefania Toselli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Emanuela Gualdi-Russo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paolo Mazzuca
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Francesco Campa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Francesco Campa.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The Project was conducted in accordance with the guidelines of the Declaration of Helsinki and was approved by the Ethics Committee of the Romagna Area Regional Health System. All participants gave written informed consent after a detailed description of the study procedures.

Additional information

Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Toselli, S., Gualdi-Russo, E., Mazzuca, P. et al. Ethnic differences in body composition, sociodemographic characteristics and lifestyle in people with type 2 diabetes mellitus living in Italy. Endocrine 65, 558–568 (2019). https://doi.org/10.1007/s12020-019-02031-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-019-02031-7

Keywords

Search

Navigation