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

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.