Od začátku války na Ukrajině přijala Česká republika více než 360 000 uprchlíků (United Nations High Council for Refugees, 2023), z nichž velkou část tvořily děti, včetně dětí s diabetem 1. typu (T1D). Celkem jsme v devíti centrech léčby dětského diabetu od února 2022 do června 2023 registrovali 124 dětí s T1D z Ukrajiny, které jsme následně sledovali ve tříměsíčních intervalech. Během prvního roku jejich pobytu v ČR došlo k významnému zlepšení průměrného HbA1c o 2,2 mmol/mol za ambulantní návštěvu (p=0,01, CI [-3,2; -1,1]). Největší pokles HbA1c jsme pozorovali u skupiny, u které byly nově nasazeny kontinuální monitory glykemie (CGM) (průměrný pokles o 2,9 mmol/mol za ambulantní návštěvu). Naše výsledky ukazují na nezastupitelnou roli CGM v managementu diabetu 1. typu.
Czechia has received over 360 000 refugees since the beginning of the war on Ukraine (United Nations High Council for Refugees, 2023). A majority of those refugees were women and children including children with type 1 diabetes (T1D). Throughout the duration of our study (February 2022 - June 2023) a total of 124 Ukrainian children with T1D presented into one of the 9 participating centers for pediatric diabetes. We followed up these children every 3 months for HbA1c, CGM values, therapy type and anthropologic measures. During the first year of their stay in Czechia, the HbA1c of these children decreased significantly by 2,2 mmol/mol per visit (p=0.01, CI [-3.2; -1.1]). HbA1c decreased the most in children who newly received CGM in Czechia with average decrease of 2,9 mmol/mol per visit. Our results show further underline the importance of CGM use in T1D management.
AIMS: Our aim was to describe the changes in therapy and diabetes control in Ukrainian war refugee children with diabetes (CwD) during the first year of their stay in Czechia. METHODS: A total of 124 CwD (62 male, 62 female) were enrolled into this observational study. Anthropometric, laboratory and diabetes management data were acquired at baseline and at 3 months intervals for 12 months. All CwD were offered a CGM device during their first visit. Generalized Estimating Equation models were fitted in order to estimate the dynamics of studied characteristics. RESULTS: Median baseline HbA1c was 58 mmol/mol (IQR [48; 73]mmol/mol) (7.5 %, IQR[6.5;8.8]%). The HbA1c decreased significantly throughout the course of the study at a pace of - 2.2 mmol/mol (-0.2 %pt.) per visit (P = 0.01, CI[-3.2;-1.1]). The pace of the decrease in the average HbA1c was significantly higher in the group of CwD who received CGM in Czechia than in those who already had it from Ukraine by 2.9 mmol/mol (0.27 %pt.) per visit (P < 0.001, CI [-4.4; -1.3]). CONCLUSIONS: The steepest decrease in HbA1c was observed in CwD with newly initiated CGM underlining its vital role in improving the glucose control of CwD regardless of their background.
- MeSH
- Diabetes Mellitus, Type 1 * drug therapy MeSH
- Child MeSH
- Glycated Hemoglobin MeSH
- Continuous Glucose Monitoring MeSH
- Blood Glucose MeSH
- Humans MeSH
- Blood Glucose Self-Monitoring MeSH
- Refugees * MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
