Diabetes affects foreigners in Spain

19 September 2008

BARCELONA — No one completely understands the cause, but doctors say that diabetes is increasing among Spain’s immigrant population. Foreigners are more likely to get diabetes during their lifetime, and also more likely to develop the disease at a younger age.

Compared to 12 percent among native Spaniards, diabetes is estimated to affect between 15 percent and 25 percent of immigrants, making it the second-biggest cause of visits by immigrants to doctors and hospitals.

"We think there are around 500,000 diabetic immigrants, diagnosed and not, most of whom are Latin American, Moroccan and Pakistani", explains Josep Franch, a General Practitioner at the Raval Sud Drassanes medical clinic in Barcelona.

Poor diet and obesity are the principal causes of the disease, although among immigrants it is possible that the effects are intensified due to either a history of eating less food or a fondness for fatty or sugary foods that are more available in the West. In addition, many foreigners’ diets are traditionally rich in carbohydrates, which affects blood sugar levels.

Altering habits
"We have to make sure they eat less by adjusting the food they are used to eating", Franch notes.

Doctors, therefore, do not tell Indians and Pakistanis to stop eating carbohydrate-rich chapatti and naan breads but instead urge them to cut back. Moroccans are told to eat less popular honey-covered pastries, while Latin Americans are encouraged to drink fewer sodas and other sugary drinks.

Besides their eating habits, other foreign customs contribute to health, including a different understanding of illness.

"Their conception of disease is different from ours. If they aren’t in pain they don’t think they are unwell, but the consequences of diabetes on health occur in the mid- to long-term", Franch notes.

For Muslims, religious factors can also affect their ability to control diabetes. During the month of Ramadan, which will last until 30 September 2008, Muslims fast during daylight hours and eat only two large meals a day, one before dawn and the other after dusk. Because such meals are often high in sugar and carbohydrates to replace energy lost during the daytime, they can cause diabetics to suffer from increased blood sugar levels with negative health effects.

Cultural advisors at hospitals have been urging Muslim diabetics to avoid fasting. "I explain to them that the Koran says anyone who is ill does not have to do it. Religion is there to help in life, not to worsen it", says Mohammed Ziri, a multicultural mediator at the Fundación Salud y Familia in Barcelona. "I also tell them that the body is a gift and that they have to take care of it until it is given to God. If they don’t believe me I tell them to ask an imam".

text: El Pais / Monica L. Ferrado / Expatica
photo credit: Khürt