HEALTH, HEALTH-CARE UTILIZATION AND LIVING-CONDITIONS IN FOREIGN-BORNDIABETIC-PATIENTS IN SOUTHERN SWEDEN

Objectives. To compare foreign-and Swedish-born diabetic subjects rega rding health care utilization, complications, clinical and socio-econo mic characteristics. Design. Cross-sectional study. Setting. All known diabetic patients living in six defined primary health care districts . Subjects. Of 1861 identified subjects aged > 25 years 90.1%, 113 for eign-and 1564 Swedish-born subjects participated. Mean time of residen ce in Sweden was 32 +/- 1.2 years, 93% > 10 years. Main outcome measur es. A standardized interview, a physical examination and an evaluation of medical records. Results. No differences were found regarding livi ng conditions or health care utilization, with the exception of higher use of home-care from public authorities in Swedish-born subjects (P < 0.05) despite no difference in dependency on help according to Katz' s ADL index. There were no major differences in objective health (glyc aemic control and complications related to diabetes) with the exceptio n of lower frequency of sensory neuropathy (P < 0.01) and peripheral v ascular disease (P < 0.05) in foreign-born subjects. The prevalence of diabetes was 2.1% (95% CI 1.7-2.5) in the foreign-born and 2.6% (95% CI 2.5-2.7) in Swedes. Foreign-born individuals were five years younge r (P < 0.001), were more often diagnosed greater than or equal to 30 y ears (P < 0.05), had a two years' shorter duration of disease (P < 0.0 01) and were less often treated with insulin (P < 0.01). Treatment wit h insulin was related to the duration and presence of complications re lated to diabetes. Conclusions. There were no major differences in obj ective health or use of health care in European migrants with diabetes mellitus, mainly Scandinavians, with short cultural distance and long residence in Sweden compared to Swedish-born diabetic patients.