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Master Thesis

Faible contrôle du diabète en population défavorisée aux Antilles françaises : la couverture sanitaire universelle ne suffit (toujours) pas

Abstract : Introduction The French Caribbean are exposed to high cardiovascular morbidity and mortality, and to poor social conditions. Little information is available concerning the diabetes in this population. Objective To explore the characteristics of diabetes and its medical managementamong French Carribean deprived adults. Methods A multicenter cross-sectional study conducted in Guadeloupe between July and December 2014 among all subjects aged 18-74 years old, unemployed and/or receiving welfare, who were performing a periodic health examination. Data collection was standardized. Diabetes was defined by an antidiabetic treatment or fasting glucose ≥ 7 mmol/l and HbA1c ≥ 6.5%, and diabetes control was defined as HbA1c < 7%. Multivariate analyses used multilevel logistic regression. Results Among the 1874 participants, 5,4% of men and 8,9% of women were diabetic. Of those, 66,7% of men and 85,6% of women had previously been informed of their diabetic status. Nearly all men and women who had been informed were treated. The proportion of controlled diabetes was estimated at 26,1% and 27%, respectively. All other things being equal, diabetes was associated with age, family history of diabetes, and waist size, in both sexes. The OR of diabetes was estimated at 5.81 (95%CI: 1.75-19.24) in women with primary level education, and at 2.21 (95%CI: 1.17-4.18) in women receiveing welfare. Conclusions In this population, there were strong social inequalities in diabetes, particularly among women. Men were insufficiently screened. Diabetes was rarely controlled. Beyond universal health care, the cardiometabolic risk prevention should be better targeted, and the quality of care needs to be improved.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01247619
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Submitted on : Wednesday, November 30, 2016 - 12:27:43 PM
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Dan Sportouch. Faible contrôle du diabète en population défavorisée aux Antilles françaises : la couverture sanitaire universelle ne suffit (toujours) pas. Médecine humaine et pathologie. 2015. ⟨dumas-01247619⟩

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