Diabetes care in pediatric refugees from Africa or Middle East – experiences from Germany and Austria based on real-world data from the DPV registry

peer-reviewed
Erstveröffentlichung
2019-07Authors
Prinz, Nicole
Konrad, Katja
Brack, Christoph
Hahn, Eva
Herbst, Antje
Wissenschaftlicher Artikel
Published in
European Journal of Endocrinology ; 181 (2019), 1. - S. 31-38. - ISSN 0804-4643. - eISSN 0804-4643
Link to original publication
https://dx.doi.org/10.1530/EJE-18-0898Faculties
Medizinische FakultätInstitutions
Institut für Epidemiologie und Medizinische BiometrieExternal cooperations
Universität zu KölnElisabeth-Krankenhaus Essen
Evangelisches Krankenhaus Oberhausen
Klinikum Leverkusen gGmbH
Deutsches Diabetes-Zentrum (DDZ)
Document version
accepted versionAbstract
Objective: With increasing migration to Europe, diabetes diagnosis and treatment of refugees became challenging. To describe current experience with pediatric refugees in Germany and Austria.
Design and Methods: 43,137 patients (<21 years) with type 1 diabetes from the diabetes patient follow-up registry (DPV) were studied, and divided by refugee status into patients born in Middle East (n=365) or Africa (n=175) and native patients (child and parents born in Germany/Austria; G/A: n=42,597). Groups were compared using multivariable regression adjusted for age, sex and diabetes duration (SAS 9.4). In refugees the first year after arrival was studied, and for native children the most recent year of care.
Results: After adjustment, HbA1c was highest in refugees (ME vs. AFR vs. G/A: 72.3±1.0 vs. 75.0±1.4 vs. 66.0±0.1 mmol/mol, each p<0.001) and microalbuminuria (9.9 vs 13.6 vs. 6.5%, each p<0.05) was more prevalent. African children experienced severe hypoglycemia (17.8±4.3 vs. 25.4±8.7 vs. 11.5±0.3 per 100 patient years) significantly more often, whereas hypoglycemia with coma (5.1±1.1 vs. 4.1±1.6 vs. 2.6±0.1 per 100 patient years) and retinopathy (2.1 vs. n/a vs. 0.2%) were significantly more common in children from Middle East compared to natives. Insulin pumps were used in a markedly larger proportion of native patients (7.4 vs. 13.2 vs. 43.0%, each p<0.001).
Conclusions: A relevant number of pediatric refugees with type 1 diabetes are treated in German/Austrian diabetes clinics. Refugee children, parents and caregivers are faced with several problems in diabetes therapy and outcome that should be addressed more intensively by pediatric diabetes teams.
EU Project uulm
INNODIA / Translational approaches to disease modifying therapy of type 1 diabetes: an innovative approach towards understanding and arresting type 1 diabetes - Sofia ref.: 115797 / EC / H2020 / 115797
Subject headings
[GND]: Diabetes mellitus Typ 1 | Naher Osten | Flüchtling[MeSH]: Diabetes mellitus, Type 1 | Africa | Middle East | Refugees
[Free subject headings]: diabetes care | diabetes registry
[DDC subject group]: DDC 610 / Medicine & health
Metadata
Show full item recordDOI & citation
Please use this identifier to cite or link to this item: http://dx.doi.org/10.18725/OPARU-36781
Prinz, Nicole et al. (2021): Diabetes care in pediatric refugees from Africa or Middle East – experiences from Germany and Austria based on real-world data from the DPV registry. Open Access Repositorium der Universität Ulm und Technischen Hochschule Ulm. http://dx.doi.org/10.18725/OPARU-36781
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