title: Impaired metabolic control and socio-demographic status in immigrant children at onset of Type 1 diabetes.
abstract: OBJECTIVE
  The aim of the present study was to compare clinical and socio-demographic conditions at the onset of Type 1 diabetes in children born to immigrant families and children born to Swedish families, and to assess whether those conditions had an impact on metabolic status.
  
  
  METHODS
  This was an observational nationwide population-based matched cohort study on prospectively recorded registry data of all children with diabetes in Sweden and their families during 2000-2010. Out of a total of 13 415 children from the Swedish Childhood Diabetes Registry (SWEDIABKIDS), 879 children born to immigrant parents were collected. To these we added 2627 children with Swedish-born parents, matched for gender, age and year of onset of Type 1 diabetes.
  
  
  RESULTS
  The proportion of low capillary pH (< 7.30) at onset was higher in the immigrant cohort [25.8% vs. 16.4% in the Swedish cohort (P < 0.001)]. HbA1c was also higher [95 mmol/mol (10.8%) vs. 88 mmol/mol (10.2%), respectively (P < 0.001)]. In a logistic regression model with low pH as the dependent variable, we were unable to reveal any significant association to socio-demographic factors, but the odds ratio for HbA1c was 0.983 (95% CI 0.976-0.991) and for plasma glucose was 0.953 (95% CI 0.933-0.973).
  
  
  CONCLUSIONS
  Children born to immigrant parents have lower capillary pH and higher HbA1c at diabetes onset. Immigrant families harbour lower socio-demographic living conditions, but this fact does not seem to influence the inferior metabolic condition at diabetes onset.
authors.affiliation: School of Health and Medical Sciences Örebro University, Örebro; Centre for Clinical Research Sörmland, Uppsala University, Uppsala; Department of Pediatrics, Mälarsjukhuset Hospital, Eskilstuna.
authors.forename: U
authors.initials: U
authors.lastname: Söderström
authors.forename: U
authors.initials: U
authors.lastname: Samuelsson
authors.forename: L
authors.initials: L
authors.lastname: Sahlqvist
authors.forename: J
authors.initials: J
authors.lastname: Åman
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000191:economics / Q000453:epidemiology / Q000503:physiopathology*; D054242:Emigrants and Immigrants; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D054624:Health Status Disparities; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D008297:Male; D016555:Matched-Pair Analysis; D010290:Parents; D012042:Registries; D012306:Risk; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013548:Sweden / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human