Problems of diabetes management in the immigrant population in Germany

AimTo compare prospectively the effect of diabetes management in the immigrant and the native population in Berlin, Germany.MethodsDiabetes patients attending a metabolic outpatient clinic in an area with a high immigrant population were studied at the start of the training program and after 12 months of participation.Results1607 of 2099 patients with at least one post-training visit (76.6%) provided analysable data. Of these 362 (22.5%) were immigrants. Initial hemoglobinA1c (HbA1c) was higher in the immigrants. Immigrants were 5 years younger and had a more recent diagnosis of diabetes. HbA1c fell by 1.4 and 1.5 percentage points in the immigrants and natives, leaving a greater proportion of the immigrants above the target value of 6.5%. Analysis of patients matched according to baseline HbA1c, sex and age showed a smaller decrease in mean HbA1c for the immigrants. The percent of patients with hypertension, obesity, dyslipidaemia or diabetic complications was comparable in both groups initially and after 12 months.ConclusionImmigrants had a higher HbA1c concentration at baseline and after 12 months compared to natives, despite a similar decline in HbA1c percentage points. More investigations are warranted to identify the causes, such as dietary habits, language difficulties, education and others.