■目前,超过200万战争难民生活在德国。暴露于战争和逃亡与高疾病负担有关,不限于精神障碍和感染。我们旨在分析来自乌克兰和叙利亚/阿富汗的儿童难民和移民在德语国家患有1型糖尿病(T1D)的糖尿病治疗和结果。
■我们将2013年1月至2023年6月期间记录的T1D患者纳入德国/奥地利/卢森堡/瑞士DPV注册表,年龄<20岁,出生在乌克兰[U],在叙利亚或阿富汗[S/A],或没有迁移背景[C]。使用物流,线性,和负二项回归模型,我们比较了糖尿病技术的使用,BMI-SDS,HbA1c值,以及在东道国治疗第一年的严重低血糖和DKA发生率。结果根据性别进行了调整,年龄,糖尿病持续时间,以及在东道国度过的时间。
■在所有年龄<20岁的T1D患者中,615人出生在乌克兰[U],624在叙利亚或阿富汗[S/A],和28,106没有迁移背景[C]。与其他两组相比,来自叙利亚或阿富汗的患者调整后的BMI-SDS较高(0.34[95%-CI:0.21-0.48][S/A]vs.0.13[-0.02-0.27][U]和0.20[0.19-0.21][C];所有p<0.001),CGM或AID系统的使用率较低(57.6%和4.6%,分别[S/A]与83.7%和7.8%[U],和87.7%和21.8%[C],所有p<0.05)和更高的严重低血糖发生率(15.3/100PY[S/A]vs.7.6/100PY[C],和vs.4.8/100PY[U],所有p<0.05)。与其他两组相比,来自乌克兰的患者调整后HbA1c较低(6.96%[95%-CI:6.77-7.14][U]vs.7.49%[7.32-7.66][S/A]和7.37%[7.36-7.39][C],所有p<0.001)。
■在东道国的第一个治疗年,年轻的叙利亚或阿富汗难民的BMI-SDS较高,降低糖尿病技术的使用率,较高的HbA1c,与年轻的乌克兰难民相比,严重低血糖的发生率更高。糖尿病专家应该意识到难民的不同文化和社会经济背景,以使糖尿病治疗和教育适应特定需求。
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.