Eighty insulin treated diabetics from North or West Africa were interviewed and compared to 80 French controls matched for sex, age and duration of insulin-therapy. Modalities and access to medical care in a specialized clinic were studied. African people were predominantly blue collar workers (49%) and French people employees (70%). The percentage of unemployed people was similar. Africans performed blood glucose self testing less frequently (35,5% vs 60,5%). Only 40% (vs 75%) participated in specific educational activities because 40% of the migrants did not read French. Despite insulin treatment being similar, metabolic control was worse among migrants (HbA1: 10,5 ± 2,4 vs 9,3% ± 1,9; p<0.01). In migrants, there was an increased prevalence of degenerative complications which did not reach statistical significance. Three parameters may explain these differences: less strict follow-up, poorer knowledge, lower socioeconomic status.

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education educational status hospitalization insulin dependent diabetes mellitus France human economic aspect diabetes mellitus social aspect priority journal comparative study hypertension geographic distribution drug efficacy social structure ethnology insulin social status Occupations migrant glycosylated hemoglobin Hemoglobin A, Glycosylated diabetic angiopathy Diabetic Angiopathies occupation Socioeconomic Factors Africa socioeconomics clinical article therapy Article blood adult migration health care quality Quality of Health Care ethnic or racial aspects insulin treatment Emigration and Immigration subcutaneous drug administration Endocrine System Middle Age drug dose drug therapy English Abstract