New Study Reveals Gaps in Type 1 Diabetes Control Among Children from Migrant Families

A new study published in *Diabetes, Obesity & Metabolism* examined 208 children with Type 1 diabetes in Italy—119 from Italian families and 89 from migrant-background families. Researchers looked at blood sugar control, use of diabetes technology, family education levels, and employment to understand what factors shape how well children manage their diabetes.

The findings revealed a significant gap: children from migrant-background families had measurably worse blood sugar control. Their average HbA1c (a key measure of long-term blood sugar levels) was 7.8% compared to 7.0% in children from Italian families. They also spent less time in their target blood sugar range—57% versus 65%—and experienced greater swings in blood sugar levels throughout the day.

One striking finding was that children from migrant-background families actually used automated insulin delivery systems (insulin pumps and continuous glucose monitors) more often than their peers—80.6% versus 68.1%. Yet despite this advantage, their blood sugar control remained worse.

This suggests that simply having access to the best tools isn't enough. The study points to a deeper issue: other factors beyond technology are affecting diabetes management in these families. When researchers looked beyond device use, they found that automated insulin delivery *was* connected to better blood sugar control overall, but other barriers seem to limit its benefit for some families.

The research uncovered stark differences in family circumstances. Among migrant-background families, 63.4% of mothers were unemployed, compared to just 16.6% of mothers in Italian families. These economic pressures can make it harder to afford diabetes supplies, access healthcare, manage time for regular appointments, or reduce stress—all of which affect diabetes care.

The study also found that children from migrant-background families presented with more severe metabolic crisis when Type 1 diabetes was first diagnosed. This may indicate that symptoms were identified later, or it could suggest differences in how the disease develops in different populations. Either way, a rougher start can set the stage for ongoing challenges.

When researchers analyzed what factors were most strongly linked to better blood sugar control, two things stood out: having access to automated insulin delivery systems and having a parent with higher education. Higher maternal education was associated with an average improvement of about 7.86% in time spent in target blood sugar range. This likely reflects better understanding of diabetes management, health literacy, and ability to navigate healthcare systems.

Migrant status itself remained a significant factor even after accounting for other differences. The researchers found that children from migrant-background families faced about 0.70% higher HbA1c on average—a meaningful difference that suggests systemic or social factors beyond what was measured in this study are at play.

This study underscores an important reality: good diabetes outcomes require more than technology alone. They depend on stable employment, accessible education about diabetes care, language support, healthcare access, and freedom from financial stress. Children from migrant-background families face multiple barriers that compound the already complex challenge of managing Type 1 diabetes.

The findings suggest that improving outcomes for these families will require addressing the underlying inequities—whether that means offering diabetes education in multiple languages, connecting families with financial assistance, ensuring adequate healthcare access, or addressing employment discrimination. Healthcare teams caring for children with Type 1 diabetes from vulnerable populations may need to look beyond glucose meters and think about the full picture of family support and resources.

Source: Diabetes, obesity & metabolism. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.