Equal access to health care may diminish the differences in outcome between native and immigrant patients with type 1 diabetes
(2014) In Pediatric Diabetes 15(7). p.519-527- Abstract
- Background/Objective: Previous studies have found that ethnicity influences glycemic control. We hypothesized that differences between Nordic and non-Nordic patients are less pronounced for children with type 1 diabetes in high incidence countries in Northern Europe. Research design and methods: We investigated patients aged 0-15 yr in national pediatric registers in Denmark (D), Iceland (I), Norway (N), and Sweden (S) (2006-2009). Ethnic origin was defined by maternal country of birth as being Nordic or non-Nordic (other countries). Results: The cohort (n= 11,908, 53.0% boys, onset age 7.7 (3.9) yr, diabetes duration 6.1 (3.6) yr, [mean, (SD)]) comprised 921 (7.7%) non-Nordic patients. The frequencies of non-Nordic patients according to... (More)
- Background/Objective: Previous studies have found that ethnicity influences glycemic control. We hypothesized that differences between Nordic and non-Nordic patients are less pronounced for children with type 1 diabetes in high incidence countries in Northern Europe. Research design and methods: We investigated patients aged 0-15 yr in national pediatric registers in Denmark (D), Iceland (I), Norway (N), and Sweden (S) (2006-2009). Ethnic origin was defined by maternal country of birth as being Nordic or non-Nordic (other countries). Results: The cohort (n= 11,908, 53.0% boys, onset age 7.7 (3.9) yr, diabetes duration 6.1 (3.6) yr, [mean, (SD)]) comprised 921 (7.7%) non-Nordic patients. The frequencies of non-Nordic patients according to country of residence were: 5.7% (D), 2.7% (I), 5.5% (N), and 9.4% (S). Sex distribution and BMI z-score did not differ between Nordic and non-Nordic patients, but non-Nordic patients were 0.5 yr younger at onset than Nordic patients (p< 0.0006). Non-Nordic patients had a lower number of daily insulin bolus injections and higher daily insulin doses compared to their Nordic peers. Patients of non-Nordic origin had slightly higher HbA1c levels (0.6-2.9 mmol/mol, p< 0.001) and, with the exception of Norway, were less frequently treated with CSII (p= 0.002) after adjusting for confounders. Conclusions: The reported differences in glycemic regulation between Nordic and non-Nordic type 1 diabetes children and adolescents in four Nordic countries are diminutive, but persist after accounting for treatment intensity. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/4865411
- author
- Fredheim, Siri ; Delli, Ahmed LU ; Rida, Heba ; Drivvoll, Ann-Kristin ; Skrivarhaug, Torild ; Bjarnason, Ragnar ; Thorsson, Arni ; Lindblad, Bengt and Svensson, Jannet
- organization
- publishing date
- 2014
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Denmark, ethnicity, Iceland, Nordic, Norway, population register, Sweden, treatment, type 1 diabetes
- in
- Pediatric Diabetes
- volume
- 15
- issue
- 7
- pages
- 519 - 527
- publisher
- Wiley-Blackwell
- external identifiers
-
- wos:000345035200007
- scopus:84907951216
- pmid:24909643
- ISSN
- 1399-543X
- DOI
- 10.1111/pedi.12157
- language
- English
- LU publication?
- yes
- id
- 4567378d-c02e-4f8d-ae80-fb283f6aa321 (old id 4865411)
- date added to LUP
- 2016-04-01 10:42:30
- date last changed
- 2022-01-26 01:47:06
@article{4567378d-c02e-4f8d-ae80-fb283f6aa321, abstract = {{Background/Objective: Previous studies have found that ethnicity influences glycemic control. We hypothesized that differences between Nordic and non-Nordic patients are less pronounced for children with type 1 diabetes in high incidence countries in Northern Europe. Research design and methods: We investigated patients aged 0-15 yr in national pediatric registers in Denmark (D), Iceland (I), Norway (N), and Sweden (S) (2006-2009). Ethnic origin was defined by maternal country of birth as being Nordic or non-Nordic (other countries). Results: The cohort (n= 11,908, 53.0% boys, onset age 7.7 (3.9) yr, diabetes duration 6.1 (3.6) yr, [mean, (SD)]) comprised 921 (7.7%) non-Nordic patients. The frequencies of non-Nordic patients according to country of residence were: 5.7% (D), 2.7% (I), 5.5% (N), and 9.4% (S). Sex distribution and BMI z-score did not differ between Nordic and non-Nordic patients, but non-Nordic patients were 0.5 yr younger at onset than Nordic patients (p< 0.0006). Non-Nordic patients had a lower number of daily insulin bolus injections and higher daily insulin doses compared to their Nordic peers. Patients of non-Nordic origin had slightly higher HbA1c levels (0.6-2.9 mmol/mol, p< 0.001) and, with the exception of Norway, were less frequently treated with CSII (p= 0.002) after adjusting for confounders. Conclusions: The reported differences in glycemic regulation between Nordic and non-Nordic type 1 diabetes children and adolescents in four Nordic countries are diminutive, but persist after accounting for treatment intensity.}}, author = {{Fredheim, Siri and Delli, Ahmed and Rida, Heba and Drivvoll, Ann-Kristin and Skrivarhaug, Torild and Bjarnason, Ragnar and Thorsson, Arni and Lindblad, Bengt and Svensson, Jannet}}, issn = {{1399-543X}}, keywords = {{Denmark; ethnicity; Iceland; Nordic; Norway; population register; Sweden; treatment; type 1 diabetes}}, language = {{eng}}, number = {{7}}, pages = {{519--527}}, publisher = {{Wiley-Blackwell}}, series = {{Pediatric Diabetes}}, title = {{Equal access to health care may diminish the differences in outcome between native and immigrant patients with type 1 diabetes}}, url = {{http://dx.doi.org/10.1111/pedi.12157}}, doi = {{10.1111/pedi.12157}}, volume = {{15}}, year = {{2014}}, }