Type 1 diabetes (T1DM) in children and adolescents of immigrated families in Emilia-Romagna (Italy).

Background and aim of the work: The etiology and natural history of T1DM are still unknown but certainly both genetics and environmental factors contribute to the development of the disease. Migrationstudies are an important tool to better understand the role of the environment. The aim of this study was to investigate some variables in diabetic children of immigrant families living in Emilia-Romagna compared with Italian diabetic children living in the same region. Methods:We recruited 73 diabetic children from immigrant families and 707 Italian diabetic children. All children were cared by Pediatric Diabetes Units of Emilia-Romagna (10 centers). The investigated variables were: gender, current age, place of birth, parents’country of origin, age at diagnosis, HbA1c and insulin regimen. Results: No significant difference with reference to gender neither among the two ethnic groups, nor in the current mean age was observed. Mean age at diagnosis in the Italian children was lower than in immigrant patients born outside Italy -group A- (7.4 vs. 9.6, p<0.000) and higher compared to those born in Italy - group B- (7.4 vs. 5.7 p<0.003; A vs. B p<0.000). The immigrant patients showed higher mean HbA1c than Italian patients (8.8 vs. 8.2, p<0.009).Conclusions: A younger age at diagnosis of T1DM in immigrant children, born in Italy compared with those born in the country of origin, and with Italian patients, suggests the existence of some environmental determinants acquired with a more westernised lifestyle. Immigrant children have significantly poorer metaboliccontrol compared with western patients.