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Observational Study
. 2021 Feb;58(2):145-152.
doi: 10.1007/s00592-020-01597-3. Epub 2020 Sep 11.

Type 1 diabetes outcomes of children born in Israel of Eritrean asylum seekers

Erella Elkon-Tamir #  1 , Yael Lebenthal #  2 , Irina Laurian  1   3 , Anna Dorfman  1   3 , Efrat Chorna  1   4 , Hagar Interator  1   5 , Galit Israeli  1 , Gil Rosen  1 , Ori Eyal  1 , Asaf Oren  1 , Avivit Brener  1
Affiliations
Observational Study

Type 1 diabetes outcomes of children born in Israel of Eritrean asylum seekers

Erella Elkon-Tamir et al. Acta Diabetol. 2021 Feb.

Abstract

Aims: Disparities in health outcomes in pediatric type 1 diabetes (T1D) based on race/ethnicity and socioeconomic position (SEP) have been reported. We compared T1D characteristics between Eritrean status-less children living in Israel and native-born Israeli children.

Methods: This observational study compared 7 Eritrean and 28 Israeli children (< 8 years old at T1D diagnosis) who were diagnosed in a single diabetes center during 2015-2019. Sociodemographic and diabetes-related data from diagnosis until the last clinic visit were retrieved from their medical files.

Results: At diagnosis, the mean age was 4.8 ± 2.2 years, 17 (48.6%) had diabetic ketoacidosis with a mean HbA1c level of 10.5 ± 2.1% (91.3 mmol/mol) and 29 (82.9%) had ≥ 2 pancreatic autoantibodies. The mean T1D duration of follow-up was 2.7 ± 1.4 years. Overall glycemic control during follow-up (> 6 months from diagnosis, mean number of samples 10.6 ± 5.2) was good, with mean, best, and peak HbA1c levels of 7.4 ± 0.8% (57.4 mmol/mol), 6.7 ± 0.7% (49.7 mmol/mol), and 8.1 ± 1.1% (65 mmol/mol), respectively. Thirty-two children (91.4%) used continuous glucose monitoring devices (CGMs), and the mean time from diagnosis to CGM initiation was 10.8 ± 14.1 months. CGM metrics: time CGM active: 95.4 ± 3.8%, mean glucose level: 170.0 ± 27.0 mg/dl (9.4 mmol/L), time-in-range: 56.4 ± 14.7%, time-below-range: 5.5 ± 5.7%, and time-above-range: 38.6 ± 16.1%. Diabetes-related parameters at diagnosis and during follow-up were similar between groups. Eritrean children had significantly lower SEPs (P < 0.001) and parental education levels (P < 0.001). Correlations between SEP and diabetes parameters and SEP and growth parameters were not significant.

Conclusions: Eritrean status-less children in Israel achieved glycemic targets similar to those of Israeli children, perhaps reflecting uniformity in the standard of care and CGM usage.

Keywords: CGM usage; Children of asylum seekers; Glycemic control; Socioeconomic position; Type 1 diabetes.

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