New Lancet review looks at progress and challenges of type 1 diabetes for children and adolescents in LMICs 100 years after discovery of insulin

Type 1 diabetes is on the rise globally, however the burden of mortality remains disproportionate in low-income and middle-income countries (LMICs) especially among children and adolescents. As 2021 celebrates 100 years of discovery of insulin, a team led by NCD Child takes a look back at the progress, global burden of type 1 diabetes (T1D) trends, and understanding of the pathogenesis and management practices related to the disease, published in The Lancet diabetes issue, ahead of World Diabetes Day on November 14. 

“A century past the discovery of insulin, there are still enormous disparities in access to this life saving intervention globally. Our review of the global situation indicates that while there are systemic bottlenecks in assuring quality care for insulin dependent diabetes among children in low and middle income countries, these are mostly addressable through cost-effective interventions,” Dr. Zulfiqar Bhutta, Executive Director, NCD Child.

The review indicates that despite much progress on improving the management of diabetes, inequities in access and availability of insulin information are persistent, and have been exacerbated by the health-system challenges during the COVID-19 pandemic.

 “A common bottleneck in LMICs is the limited availability of data on incidence, coverage of interventions, cost and sustainable availability of insulin and related technologies. Health systems as a whole need to be strengthened; given poor financing, fewer trained health workforce, supply chain limitations for essential medicines and technologies, and representative health data as major issues,” Dr. Apoorva Gomber, NCD Child Young Leader and young person living with T1D.  

Opportunities to improve access to insulin and related-essential technologies to improve the management of T1D requires more investments into human resources, technologies, and health care. Further research in LMICs is also needed to better understand the burden, risk factors and implementation strategies for managing T1D.

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