Type 2 diabetes mellitus management among Ghanaian migrants resident in three European countries and their compatriots in rural and urban Ghana - The RODAM study

Aims: To compare Type 2 Diabetes Mellitus (T2DM) awareness, treatment and control between Ghanaians resident in Ghana and Europe. Methods: Comparisons were made for the 530 participants of the Research on Obesity and Diabetes among African Migrants (RODAM) study with T2DM (25-70 years) living in Amsterdam, Berlin, London, urban Ghana and rural Ghana. We used logistic regression to assess disparities with adjustment for age, sex and education. Results: T2DM awareness was 51% in rural Ghana. This was lower than levels in Europe ranging from 73% in London (age-sex adjusted odds ratio (OR) = 2.7; 95% CI = 1.2-6.0) to 79% in Amsterdam (OR = 4.7; 95% CI = 2.3-9.6). T2DM treatment was also lower in rural Ghana (37%) than in urban Ghana (56%; OR = 2.6; 95% CI = 1.3-5.3) and European sites ranging from 67% in London (OR = 3.4; 95% CI = 1.5-7.5) to 73% in Berlin (OR = 6.9; 95% CI = 2.9-16.4). In contrast, T2DM control in rural Ghana (63%) was comparable to Amsterdam and Berlin, but higher than in London (40%; OR = 0.4; 95% CI = 0.2-0.9) and urban Ghana (28%; OR = 0.3; 95% CI = 0.1-0.6). Conclusions: Our findings suggest that improved detection and treatment of T2DM in rural Ghana, and improved control for people with diagnosed T2DM in London and urban Ghana warrant prioritization. Further work is needed to understand the factors driving the differences. (C) 2017 Elsevier B.V. All rights reserved.