Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2022 Jul 22:13:937156.
doi: 10.3389/fendo.2022.937156. eCollection 2022.

Precariousness, Diabetes Control and Complications in French Guiana

Samuel Linière  1 , Mathieu Nacher  2 , Kinan Drak Alsibai  3 , Mayka Mergeayfabre  2 , Nezha Hafsi  4 , Aurelie Charpin  2 , Caroline Misslin-Tritsch  5 , Jean-François Carod  6 , Jean Markens Aurelus  4 , Bertrand De Toffol  7 , André Ntoutoum  4 , John Bukasa Kakamba  4 , Magalie Demar  8   9 , Jeannie Helene-Pelage  10 , Antoine Adenis  2 , Nadia Sabbah  2   4
Affiliations
Multicenter Study

Precariousness, Diabetes Control and Complications in French Guiana

Samuel Linière et al. Front Endocrinol (Lausanne). .

Abstract

Aims: The social parameters of an individual impact the incidence of cardiovascular diseases. French Guiana, an overseas French territory with a lower standard of living than France, has a prevalence of diabetes mellitus that is twice that of mainland France. In this context we aimed to study the relation between precariousness, diabetes complications and glycemic control.

Methods: A multicenter prospective cohort was initiated since May 2019. 1243 patients were included and their outcomes and history were compared between the precarious and non-precarious based on their EPICES score, a score that measures social isolation and precariousness.

Results: 73.3% of the sample was considered precarious. Retinopathy was significantly more frequent among the deprived. There were no significant differences for other macro or microvascular complications.There was a significant difference in Glycated Haemoglobin between the precarious and non-precarious groups (8.3% (67 mmol/l) vs 8.8% (73mmol/l)). After adjusting for potential confounders, precariousness was no longer associated with poor glycemic control; the independent factors significantly associated with poor glycemic control were: not being fluent in French, having creole or portugese as mother language, and not having any insurance.

Conclusions: Precariousness is a risk factor for retinal complications in patients with diabetes mellitus in French Guiana. In this chronic disease, the universal healthcare system alleviates health inequalities for many, but not all, diabetic complications.Translation and cultural mediation may further reduce health inequalities in this multicultural territory where a substantial proportion of the population is not fluent in French.

Keywords: diabetes; infections; precariousness; retinopathy; stroke.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

    1. Marmot M, Allen J, Bell R, Bloomer E, Goldblatt P. Consortium for the European Review of Social Determinants of Health and the Health Divide (2012) WHO European Review of Social Determinants of Health and the Health Divide. Lancet Lond Engl 380(9846):1011–29. doi: 10.1016/S0140-6736(12)61228-8 - DOI - PubMed
    1. Mackenbach JP, Stirbu I, Roskam A-JR, Schaap MM, Menvielle G, Leinsalu M, et al. . Socioeconomic Inequalities in Health in 22 European Countries. N Engl J Med (2008) 358(23):2468–81. doi: 10.1056/NEJMsa0707519 - DOI - PubMed
    1. Power C, Matthews S. Origins of Health Inequalities in a National Population Sample. Lancet Lond Engl (1997) 350(9091):1584–9. doi: 10.1016/S0140-6736(97)07474-6 - DOI - PubMed
    1. Stringhini S, Dugravot A, Shipley M, Goldberg M, Zins M, Kivimäki M, et al. . Health Behaviours, Socioeconomic Status, and Mortality: Further Analyses of the British Whitehall II and the French GAZEL Prospective Cohorts. PloS Med (2011) 8(2):e1000419. doi: 10.1371/journal.pmed.1000419 - DOI - PMC - PubMed
    1. Ward E, Jemal A, Cokkinides V, Singh GK, Cardinez C, Ghafoor A, et al. . Cancer Disparities by Race/Ethnicity and Socioeconomic Status. CA Cancer J Clin (2004) 54(2):78–93. doi: 10.3322/canjclin.54.2.78 - DOI - PubMed

Publication types

Substances