Changing Diabetes® in Children
Urgent action is needed to improve the conditions for children with diabetes in the world’s poorest countries.
Childhood diabetes has a high mortality rate in poor countries. The life expectancy for a child with newly diagnosed type 1 diabetes in sub-Saharan Africa is typically less than one year.
While access to insulin is generally difficult in poor countries, many children die in hospitals even where insulin is available. Parents often lack money to pay for transportation to hospitals. Diabetes in children typically shows in children as an acute crisis, and a general problem is misdiagnosis due to lack of awareness and appropriate testing equipment resulting in wrong, sometimes fatal, treatment.
In December 2008, Novo Nordisk announced an ambitious 5-year programme to change the future of these children. The programme, called ‘Changing Diabetes® in Children’, will begin in 2009 with an initial roll-out in Cameroon, Democratic Republic of Congo, Guinea- Conakry, Tanzania and Uganda. Hubs with a series of satellite centres specially trained healthcare personnel will be set up in connection with existing hospitals and clinics to ensure access to diagnosis, patient education and treatment – including free insulin. The programme will ensure the build-up of a registry system ensuring proper monitoring.
The programme, which supports the fourth UN Millennium Development Goal focusing on reducing child mortality, builds on an approach which the company first applied in Tanzania in 2006. Children with type 1 diabetes are referred to a Novo Nordisk funded diabetes children clinic for specialised care, which has led to dramatically decreased mortality. Emergency admissions have also dropped. The company hopes that by expanding this approach to other countries many more diabetic children may be saved, eventually reaching the target of 10,000 by 2015.
Did you know?
• Diabetes is the fourth leading cause of global death by disease
• 80% of people with diabetes live in low and middle income countries
• Diabetic ketoacidosis (DKA) is the leading cause or mortality and morbidity in children with type 1 diabetes. DKA in children develops quickly and is, much more than in adults, related to severe morbidity and sequels of associated medical complications
• Studies carried out recently in Zambia, Mali and Mozambique highlight a stark reality: a person requiring insulin for survival in Zambia will live an average of 11 years; a person in Mali can expect to live for 30 months; in Mozambique a person requiring insulin will be dead within 12 months
• In some cases indispensable for survival, and in others necessary to maintain normal blood sugar levels, insulin remains under utilised in many developing countries, among others due to culturally based misconceptions and chronic shortages of supplies.
Novo Nordisk's comprehensive programmes in the field of access to diabetes care target disadvantaged communities and the most vulnerable populations with the least access to care. These groups include people living in the countries classified by the United Nations as least developed countries (LDCs); low-income groups in emerging economies; migrants in developed countries; women and children.
While affordability of care is a significant barrier, there are other obstacles that are just as critical. These include lack of awareness about diabetes, lack of knowledge among healthcare providers in diagnosing and treating the condition, too few hospitals and clinics equipped to treat diabetes, and a lack of national healthcare strategies to tackle the epidemic. Seeking to overcome these barriers, Novo Nordisk puts considerable efforts into building sustainable solutions that provide immediate relief while also building long-term capacity.