Diabetes care and outcomes of pediatric refugees and migrants from Ukraine and Syria/Afghanistan with type 1 diabetes in German-speaking countries.

Autor:	Auzanneau M; Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.; German Center for Diabetes Research (DZD), Neuherberg, Germany., Reinauer C; Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany., Ziegler J; Pediatric Diabetology, University Children's Hospital Tübingen, Tübingen, Germany., Golembowski S; Department of Pediatrics, Sana Hospital Lichtenberg, Berlin, Germany., de Beaufort C; Department of Pediatric Diabetes and Endocrinology, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg.; Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-Belval, Luxembourg., Schöttler H; Diabetology and Endocrinology, Darmstädter Kinderkliniken Prinzessin Margaret, Darmstadt, Germany., Hahn E; Department of Pediatrics and Adolescent Medicine, St. Agnes-Hospital Bocholt - Klinikum Westmünsterland, Bocholt, Germany., Mirza J; Kinderkrankenhaus Amsterdamer Straße, Klinik für Kinder- und Jugendmedizin, Paediatric Diabetology, Kliniken Köln, Köln, Germany., Galler A; Charité - Universitätsmedizin Berlin, Sozialpädiatrisches Zentrum, Berlin, Germany., Wurm M; Department of Pediatrics, Klinik St. Hedwig, University Hospital Regensburg, Krankenhaus Barmherzige Brüder, Regensburg, Germany., Holl RW; Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.; German Center for Diabetes Research (DZD), Neuherberg, Germany.
Jazyk:	angličtina
Zdroj:	Frontiers in endocrinology [Front Endocrinol (Lausanne)] 2024 Jun 07; Vol. 15, pp. 1403684. Date of Electronic Publication: 2024 Jun 07 (Print Publication: 2024).
DOI:	10.3389/fendo.2024.1403684
Abstrakt:	Introduction: Currently, over two million war refugees live in Germany. Exposure to war and flight is associated with a high burden of diseases, not limited to mental disorders and infections. We aimed to analyze diabetes treatment and outcomes of pediatric refugees and migrants from Ukraine and Syria/Afghanistan with type 1 diabetes (T1D) in German-speaking countries. Materials and Methods: We included patients with T1D documented between January 2013 and June 2023 in the German/Austrian/Luxembourgian/Swiss DPV registry, aged < 20 years, born in Ukraine [U], in Syria or Afghanistan [S/A], or without migration background [C]. Using logistic, linear, and negative binomial regression models, we compared diabetes technology use, BMI-SDS, HbA1c values, as well as severe hypoglycemia and DKA rates between groups in the first year of treatment in the host country. Results were adjusted for sex, age, diabetes duration, and time spent in the host country. Results: Among all patients with T1D aged < 20 years, 615 were born in Ukraine [U], 624 in Syria or Afghanistan [S/A], and 28,106 had no migration background [C]. Compared to the two other groups, patients from Syria or Afghanistan had a higher adjusted BMI-SDS (0.34 [95%-CI: 0.21-0.48] [S/A] vs. 0.13 [- 0.02-0.27] [U] and 0.20 [0.19-0.21] [C]; all p<0.001), a lower use of CGM or AID system (57.6% and 4.6%, respectively [S/A] vs. 83.7% and 7.8% [U], and 87.7% and 21.8% [C], all p<0.05) and a higher rate of severe hypoglycemia (15.3/100 PY [S/A] vs. 7.6/100 PY [C], and vs. 4.8/100 PY [U], all p<0.05). Compared to the two other groups, patients from Ukraine had a lower adjusted HbA1c (6.96% [95%-CI: 6.77-7.14] [U] vs. 7.49% [7.32-7.66] [S/A] and 7.37% [7.36-7.39] [C], all p<0.001). Discussion: In their first treatment year in the host country, young Syrian or Afghan refugees had higher BMI-SDS, lower use of diabetes technology, higher HbA1c, and a higher rate of severe hypoglycemia compared to young Ukrainian refugees. Diabetologists should be aware of the different cultural and socioeconomic backgrounds of refugees to adapt diabetes treatment and education to specific needs. Competing Interests: 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. The handling editor KB declared a shared affiliation with the author AG at the time of review. (Copyright © 2024 Auzanneau, Reinauer, Ziegler, Golembowski, de Beaufort, Schöttler, Hahn, Mirza, Galler, Wurm and Holl.)
Databáze:	MEDLINE
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