A4D’s one of a kind study focusing on Type 1 Diabetes (T1D) in Laos has been published in Pediatric Diabetes official journal of International Society for Pediatric and Adolescent Diabetes. It is the first ever published data about T1D in the country, providing a glance at existing demographic situation, health outcomes and access to basic health care.
Like many other lower middle income countries (LMIC), management of T1D in Laos is challenging because the costs of treatment are often prohibitive. Insulin and regular blood glucose testing are essential for the survival of people with T1D. Limited access to these will lead to serious diabetes complications like diabetic ketoacidosis, severe hypoglycemia and unnecessary mortality. Access to skilled and trained healthcare professionals is also limited due to resource constraints. We at Action4Diabetes (A4D) are trying to change this.
In partnership with the Laos government since 2016, A4D has been providing access to free insulin, blood glucose monitoring kits, HbA1c testing, and emergency care at hospital for children and young people (CYP) with T1D in the country. A4D also provides ongoing training for healthcare professionals in order to build up the local health capacity in T1D management..
A snapshot of the status of T1D in Laos:
Universal health coverage for diabetes in Laos does not include insulin treatment and self-monitoring of blood glucose (SMBG).
Lack of knowledge about carb counting and insulin analogue leads to higher mortality
Of the 53 CYP with T1D who were enrolled in the A4D programme during the study period, 30 (57%) were male and 23 (43%) were female.
Twenty-three of the 55 CYP (42%) were from Vientiane Capital City prefecture, and the other 32 (58%) were from 14 of the 17 Laotian provinces.
We found that 57% of the Laotian CYP presented in DKA at the onset of T1D, compared to lower rates ranging from 19.5% to 43.8%among 59,000 children with newly diagnosed T1D in Europe, NorthAmerica, and Australia in 2006–2016.22 The exact reasons for the disparity were not the subject of investigation in this study. However, it would be reasonable to attribute the higher DKA rates at diagnosis among the Laotian CYP to factors such as the lack of awareness ofT1D in the general Laotian population and the long distances that patients need to travel to reach a hospital for medical attention,thereby leading to late presentation at disease onset.
The average HbA1c was 8.7% (72 mmol/mol), which is above the recommended target of <7.5% by the International Society for Pediatric and Adolescent Diabetes (ISPAD) and this could probably be due to the use of twice daily insulin regimen.
It is evident that close partnership between governments and NGOs has enormous potential in developing sustainable and locally owned solutions for diabetes care in children and young people with T1D residing in LMICs.
Read full paper here
Contact us today and find out how you can partner with us to give health and hope for young people with T1D in South-East Asia.