Socioeconomic and Linguistic Factors in Paediatric Type 1 Diabetes: Exploring Glycemic Outcomes, Technology Use, and Residual Beta‐Cell Function in Migrant‐Background Populations

Abstract

ABSTRACT Aims To investigate associations between migrant status, socioeconomic factors (SES), and residual beta‐cell function and glycemic outcomes in paediatric type 1 diabetes. Methods Retrospective study of 208 children (median [IQR] age 11 [8–14] years; 119 Italian, 89 from migrant‐background families) with glucometric (HbA1c, TIR, TITR, TAR, CV), SES (maternal/paternal education, language, income), and metabolic data. Univariable and exploratory multivariable regression analyses identified factors associated with glycemic control. Results Children from migrant‐background families presented with more severe metabolic crisis at onset (pH 7.28 vs. 7.35, p = 0.047; C‐peptide 0.24 vs. 0.32 ng/mL, p = 0.010). Despite higher AID usage (80.6% vs. 68.1%), children from migrant‐background families showed significantly worse glycemic control: higher HbA1c (7.8% vs. 7.0%, p < 0.001), lower TIR (57% vs. 65%, p = 0.004), and greater glycemic variability (CV 39.3% vs. 35.0%, p < 0.001). Socioeconomic disparities were marked, with 63.4% of migrant mothers unemployed (vs 16.6%, p < 0.001). In multivariable analysis, migrant status was associated with higher HbA1c (β +0.70, p < 0.001), while AID use (β +10, p < 0.001) and high maternal education (β +7.86, p = 0.004) were associated with higher TIR. Conclusions In this retrospective cohort, children and adolescents from migrant‐background families had poorer glycemic outcomes despite high AID uptake and comparable C‐peptide levels at follow‐up. Technology provision alone may be insufficient to eliminate socioeconomic and linguistic disparities in glycemic control, and interventions targeting education, language support, and family‐level self‐management capacity may be beneficial.