RISK-FACTORS FOR POOR GLYCEMIC CONTROL IN DIABETIC CHILDREN IN FRANCE- IMMIGRANT VERSUS NONIMMIGRANT MOTHERS

OBJECTIVE - To test whether immigrant versus nonimmigrant origin, amon g others factors, is associated with differences in glycemic control i n diabetic children. RESEARCH DESIGN AND METHODS - A cross-sectional m ulticenter survey was performed in 165 French diabetic children aged 7 -13 years and their parents. HbA(1c) was measured by high-performance liquid chromatography in a single laboratory (reference value. 5.1 +/- 0.6%). Standardized questionnaires were used to evaluate cognitive, f amilial, and socioeconomic factors and adherence to diabetes regimen. RESULTS - The mother's place of birth was found to account for 6.6% of the HbA(1c) variance. Two groups of children were identified with Fre nch-speaking immigrant (n = 27) and native French mothers (n = 138) wh o had significantly different HbA(1c) values of 9.1 +/- 8% vs. 8.1 +/- 1.4%, respectively (P < 0.001). Adherence to diabetes treatment was s ignificantly lower in immigrant mothers for diet and insulin changes ( P < 0.01), as well as their level of diabetes knowledge (P < 0.01). Th is immigrant group had no significant differences in parents' socioeco nomic status, educational. background, family status, family functioni ng, diabetes education background, and social support compared with th e native French mothers' group. CONCLUSIONS - Despite no differences i n socioeconomic status, a group of children with less well-controlled diabetes was identified by the mother's place of birth. Cultural facto rs have a crucial importance in glycemic control in diabetic children and in parents' adherence to treatment and must be taken into account in the development of educational programs.