Equal access to health care may diminish the differences in outcome between native and immigrant patients with type 1 diabetes.

• Published in: Pediatric Diabetes
• Main Authors: Fredheim, Siri, Delli, Ahmed, Rida, Heba, Drivvoll, Ann-Kristin, Skrivarhaug, Torild, Bjarnason, Ragnar, Thorsson, Arni, Lindblad, Bengt, Svensson, Jannet
• Other Authors: Herlev Hosp, Dept Pediat, Copenhagen, Denmark, Univ Copenhagen, Fac Hlth & Med Sci, Copenhagen, Denmark, Lund Univ, CRC, Dept Clin Sci, Skane Univ Hosp SUS, Malmo, Sweden, Oslo Univ Hosp, Dept Pediat Med, Oslo, Norway, Landspitali Univ Hosp, Childrens Med Ctr, Reykjavik, Iceland, Univ Iceland, Dept Pediat, Reykjavik, Iceland, Gothenburg Univ, Sahlgrenska Acad, Inst Clin Sci, Dept Pediat, Gothenburg, Sweden
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley-Blackwell 2015
• Subjects: Sykursýki; Meðferð; Diabetes Mellitus; Type 1; Ethnic Groups; Norway; Iceland
• Online Access: http://hdl.handle.net/2336/550899; https://doi.org/10.1111/pedi.12157

To access publisher's full text version of this article click on the hyperlink at the bottom of the page 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. 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). 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. 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. Nordic Diabetes Registries (Denmark, Norway) Icelandic Thorvaldsen's Foundation (Island) Swedish Board of Health and Welfare (Swediabkids)