ESPE Yearbook of Paediatric Endocrinology

Brief Summary: This multicenter, observational study compared the treatment of diabetes and outcomes between 2 distinct refugee communities in German-speaking countries and among native children in the same countries. The use of advanced diabetes technologies, such as insulin pumps or automated insulin delivery (AID) systems, is restricted by the refugee status. Additionally, parameters such as HbA1c and body mass index (BMI) have been identified to differ by country of origin of refugees.

There is a scarcity of data on the management of type 1 diabetes (T1D) in war refugee children, who are particularly susceptible to health issues. This study used data from the German/Austrian/Luxembourgian/Swiss diabetes prospective follow-up registry (DPV). The authors compared diabetes treatment and outcomes in the host country of children with Type 1 Diabetes (T1D) from Ukraine (U), refugees from Syria/Afghanistan (S/A), and those who never migrated (Controls). Compared to controls, both refugee groups had lower use insulin pumps (U: 24.9%, S/A: 19.9%, Controls: 59.1%) and AID (U: 8.8%, S/A: 4.7%, Controls: 24.4). Continuous glucose monitor use was considerably lower among S/A refugees (U: 81.6%, S/A: 54.5%, Controls: 85.5%). BMI SDS was relatively higher among S/A refugees and controls (U: 0.02, S/A: 0.24, Controls: 0.22), and S/A refugees had a higher HbA1c (U: 7.22%, S/A: 7.59%, Controls: 7.2%). The prevalence of severe hypoglycemia was elevated among S/A refugees.

These findings highlight the need for a more comprehensive examination of the issue of immigrants in order to improve their healthcare, which compares two distinct groups of refugees from various origins with local individuals living with T1D in the host country. The countries of origin and the diets of immigrant children with T1D, as well as language education and health literacy, should be taken into account.

References: 1. Moore TH, Dawson S, Wheeler J, Hamilton-Shield J, Barrett TG, Redwood S, et al. Views of children with diabetes from underserved communities, and their families on diabetes, glycaemic control and healthcare provision: A qualitative evidence synthesis. Diabetes Med. (2023) 40:e15197. doi: 10.1111/dme.151972. Neuman V, Vavra D, Drnkova L, Pruhova S, Plachy L, Kolouskova S, et al. Introduction of continuous glucose monitoring (CGM) is a key factor in decreasing HbA1c in war refugee children with type 1 diabetes. Diabetes Res Clin Pract. (2024) 208:111118. doi: 10.1016/j.diabres.2024.111118.