Diabetologia ( IF 8.4 ) Pub Date : 2021-10-16 , DOI: 10.1007/s00125-021-05586-1 Charles Agyemang 1 , Eva L van der Linden 1, 2 , Louise Bennet 3, 4
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European populations are ethnically and culturally diverse due to international migration. Evidence indicates large ethnic inequalities in the prevalence of type 2 diabetes. This review discusses the burden of type 2 diabetes and its related complications, and the potential explanatory mechanisms among migrants in Europe. The current available data suggest that the rate of type 2 diabetes is higher in all migrant groups and that they develop this disease at an earlier age than the host European populations. The level of diabetes awareness among migrant populations is high, but glycaemic control remains suboptimal compared with Europeans. The culturally adapted lifestyle modification intervention trials to prevent type 2 diabetes mainly focus on South Asian adults in Europe. Diabetes-related microvascular and macrovascular complications remain a major burden among migrant populations in Europe. Earlier studies found higher mortality rates among migrants, but recent studies seem to suggest a shifting trend in favour of first-generation migrants. However, the extent of the burden of type 2 diabetes varies across migrant groups and European countries. Despite the higher burden of type 2 diabetes among migrants, the key underlying factors are not well understood mainly due to limited investment in basic science research and development of prospective cohort studies. We hypothesise that the underlying risk factors for the high burden of type 2 diabetes and its related complications in migrants are multifaceted and include pre-migration factors, post-migration factors and genetic predispositions. Given the multi-ethnic nature of the current European population, there is a clear need for investment in research among migrant populations to gain insight into factors driving the high burden of type 2 diabetes and related complications to facilitate prevention and treatment efforts in Europe.
Graphical abstract
中文翻译：
欧洲移民的 2 型糖尿病负担：揭示因果关系
由于国际移民，欧洲人口在种族和文化上具有多样性。证据表明 2 型糖尿病的患病率存在很大的种族不平等。本综述讨论了 2 型糖尿病及其相关并发症的负担，以及欧洲移民的潜在解释机制。目前可用的数据表明，所有移民群体的 2 型糖尿病发病率都较高，而且他们患上这种疾病的年龄比东道国欧洲人群更早。流动人口对糖尿病的认识水平很高，但与欧洲人相比，血糖控制仍不理想。旨在预防 2 型糖尿病的文化适应生活方式改变干预试验主要集中在欧洲的南亚成年人身上。糖尿病相关的微血管和大血管并发症仍然是欧洲移民人口的主要负担。早期的研究发现移民的死亡率更高，但最近的研究似乎表明趋势有利于第一代移民。然而，2 型糖尿病的负担程度因移民群体和欧洲国家而异。尽管移民中 2 型糖尿病的负担较高，但主要由于对基础科学研究和前瞻性队列研究开发的投资有限，关键的潜在因素尚不清楚。我们假设移民中 2 型糖尿病及其相关并发症的高负担的潜在风险因素是多方面的，包括移民前因素、移民后因素和遗传易感性。
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