Migration background and diabetes technology use at diagnosis and follow-up in children and adolescents with type 1 diabetes: a single-centre study

AIMS: To investigate whether migration background is associated with diabetes technology use at diagnosis and during follow-up in children and adolescents with type 1 diabetes. METHODS: This cross-sectional study included children and adolescents aged 4-19 years with type 1 diabetes duration ≥ 1 year. Insulin pump therapy at diagnosis and diabetes technology use at follow-up (defined as insulin pump therapy or automated insulin delivery [AID]) were compared between participants with and without migration background. Multivariable logistic regression was used to assess factors associated with technology use. RESULTS: A total of 143 participants (mean age 13.2 ± 3.7 years) were included, of whom 24.5% had a migration background. At diabetes onset, insulin pump therapy was less frequent in participants with migration background compared to those without (28.6% vs. 50.0%, p = 0.027). At follow-up, diabetes technology use was numerically lower in participants with migration background (60.0% vs. 76.8%); however, the difference did not reach statistical significance (p = 0.052). In adjusted analyses, migration background was not significantly associated with diabetes technology use at follow-up (OR 2.33, 95% CI 0.92-5.89), whereas younger age and longer diabetes duration were independently associated with technology use. CONCLUSIONS: Children with migration background were less likely to receive insulin pump therapy at diagnosis. At follow-up, differences in diabetes technology use were smaller and not statistically significant. These findings are consistent with the hypothesis of delayed technology uptake, although longitudinal studies are required to determine the timing of diabetes technology initiation.