מילות מפתח: Type 2 diabetes, Immigration, Macrovascular complications, Microvascular complications, Mortality

רקע מדעי ומטרה:

Immigrants, particularly those moving from lower to higher-income countries, often exhibit a heightened susceptibility to non-communicable diseases, such as Type 2 diabetes (T2D), which may present with different complications compared to the native population. We aimed to investigate the long-term health consequences of type 2 diabetes in Ethiopian-born who immigrated to Israel, compared to the Israeli-born Jewish population.

שיטות:

A community-based cohort study using Clalit Health Services data. The study included 78,637 individuals diagnosed with T2D between 2000-2011. During Follow-up which lasted until December 2021 (median follow-up 15.6 years), T2D outcomes rates were measured among 4,568 Ethiopian-born Jews and their Israeli-born counterparts. Multivariate analyses were conducted to obtain hazard ratios with adjustment for demographic, clinical and comorbid factors at the onset of the disease and after a 5-year follow-up period.

תוצאות:

Ethiopian-born individuals exhibited higher risk for microvascular complications (HR 1.12 95% CI 1.06-1.18) but lower for macrovascular complications (HR 0.73 95% CI 0.67-0.79) and mortality (HR 0.76 95% CI 0.7-0.82) compared to the Israeli-born. Ethiopia-born had lower rates of cardiovascular risk factors, but displayed later with poorer diabetes control and medication adherence. Furthermore, an extended period of residence in Israel was associated with an increased likelihood of developing macrovascular complications, particularly notable after 10 years, with a lesser impact on microvascular complications.

מסקנות:

Ethiopian-born individuals exhibit a distinct pattern of T2D-related outcomes, with higher propensity for microvascular complications, particularly nephropathy. However, they appear to have a lower risk of macrovascular complications and all-cause mortality.

חשיבות לרפואת המשפחה:

Immigrants may need targeted primary prevention interventions.