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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 10, 2016; 7(3): 34-44
Published online Feb 10, 2016. doi: 10.4239/wjd.v7.i3.34
Diabetes in migrants and ethnic minorities in a changing World
Luca Montesi, Maria Turchese Caletti, Giulio Marchesini
Luca Montesi, Maria Turchese Caletti, Giulio Marchesini, Department of Medical and Surgical Sciences, S.Orsola-Malpighi Hospital, “Alma Mater Studiorum” University, I-40138 Bologna, Italy
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and approval of the final version.
Supported by A research grant from the Department of Medical and Surgical Sciences, University of Bologna (to Luca Montesi), No. 106/2014.
Conflict-of-interest statement: Luca Montesi, Maria Turchese Caletti and Giulio Marchesini declare no conflicts of interests in relation to the materials presented in this review article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Giulio Marchesini, MD, PhD, Department of Medical and Surgical Sciences, S.Orsola-Malpighi Hospital, “Alma Mater Studiorum” University, Via Massarenti n°9, I-40138 Bologna, Italy. giulio.marchesini@unibo.it
Telephone: +39-051-2144889 Fax: +39-051-6364502
Received: July 31, 2015
Peer-review started: August 3, 2015
First decision: October 13, 2015
Revised: December 14, 2015
Accepted: December 29, 2015
Article in press: January 4, 2016
Published online: February 10, 2016
Processing time: 178 Days and 17.9 Hours
Abstract

On a worldwide scale, the total number of migrants exceeds 200 million and is not expected to reduce, fuelled by the economic crisis, terrorism and wars, generating increasing clinical and administrative problems to National Health Systems. Chronic non-communicable diseases (NCD), and specifically diabetes, are on the front-line, due to the high number of cases at risk, duration and cost of diseases, and availability of effective measures of prevention and treatment. We reviewed the documents of International Agencies on migration and performed a PubMed search of existing literature, focusing on the differences in the prevalence of diabetes between migrants and native people, the prevalence of NCD in migrants vs rates in the countries of origin, diabetes convergence, risk of diabetes progression and standard of care in migrants. Even in universalistic healthcare systems, differences in socioeconomic status and barriers generated by the present culture of biomedicine make high-risk ethnic minorities under-treated and not protected against inequalities. Underutilization of drugs and primary care services in specific ethnic groups are far from being money-saving, and might produce higher hospitalization rates due to disease progression and complications. Efforts should be made to favor screening and treatment programs, to adapt education programs to specific cultures, and to develop community partnerships.

Keywords: Migrants; Ethnic minorities; Diabetes; Health Systems; Non communicable diseases; Genetics; Socioeconomic development; Social determinants

Core tip: At global level the phenomenon of migration of people is not expected to slow down in the next years, generating a multitude of clinical problems and economic costs for the National Health System. The increasing burden of chronic diseases, particularly diabetes, in migrant minority populations is today a major public health challenge for several countries, mainly in Europe, fuelled by the economic crisis, inequalities, terrorism and wars. Even in a universalistic healthcare system, differences in socioeconomic status and barriers generated by the present culture of biomedicine might make high-risk ethnic minorities under-treated and not protected against inequalities. Our objective is to pinpoint the problems arising in the prevention and treatment of diabetes on a worldwide scale, aiming to give support to healthcare systems in the provision of effective interventions.