A huge increase in the number of children and youth living with type 1 diabetes (T1D) was recorded between 2007 and 2016 in the West African country of Mali.
A new study shows that this increase is likely due to improvements in diagnosis and care, resulting in fewer young people dying from T1D and complications.
Before Life for a Child joined forces with local partner Santé Diabète, in 2007, there were only 28 young people living with T1D in Mali. At this time, very limited care was available, and sadly most young people died within a couple of years of a T1D diagnosis. However, since Life for a Child began supporting Santé Diabète, support has been consistently provided for young people under the age of 26. This care is provided in partnership with the Mali government health services.
We started with the basics; providing young people with the insulin and supplies they needed to manage their T1D. Then in 2013, we ran a poster campaign in health facilities across the country, raising awareness of the symptoms of T1D to prevent deaths from misdiagnosis or late diagnosis of ketoacidosis—these were sadly very common before the intervention took place. A whopping thousand and six hundred posters in French and the local language Bambara were distributed to all diabetes clinics in all regions of Mali and the capital Bamako, as well as patient associations.
The campaign was very successful: More and more children were being diagnosed with T1D and referred to Santé Diabète for supplies and support.
The graph below shows the number of T1D cases between 2007 and 2016. The number of diagnosed cases of T1D rose sharply from low levels in 2007. There was a peak in 2014 – the year after the poster campaign.
Today over 700 young people are supported by Life for a Child and Santé Diabète across Mali. These young people have access to diabetes education materials and can connect with each other at education workshops.
The authors are hopeful that findings from this study will serve as advocacy material to help drive awareness on the impacts that interventions have on improving survival rates in less-resourced settings. Further, we are optimistic that these data will assist local sustainability efforts; the government is doing more and more to help.
This is an important study that shows basic provision of care saves lives. However, there is much more to do. The study explains that the number of young people with type 1 in Mali may still be underestimated, with young people dying undiagnosed. You can help us continue this important work by making a donation to Life for a Child today.
You can see the study here or email us to request a copy at firstname.lastname@example.org.
Gahan is an 8-year-old boy from a small village in Bangladesh. He is a smart young man and hopes one day to become an engineer. As well as working hard at school, he loves to spend time outdoors with friends, playing cricket and badminton in the streets around his home.
Gahan’s father is a fisherman and his mother is a homemaker. He is their eldest son and has a 5-month-old little sister.
When Gahan was three years old his father was concerned to see his son losing weight, wetting the bed and often too tired to play outside with his friends. Over a number of weeks Gahan’s health deteriorated until it became so serious that they thought their child might die.
Gahan’s parents took him to the local hospital where they found that he had a very high blood glucose level. Staff quickly referred him to the Life for a Child partner center, which they knew would be better equipped to deal with Gahan’s diagnosis.
When the family arrived at the center they were disorientated and fearful.
“It seemed like the sky has fallen down on us. We felt hopeless.” Gahan’s Father.
Gahan was admitted to the hospital and doctors worked to stabilize his blood sugar. He spent 15 days and nights there, being nursed back to health, while his parents received diabetes education.
It was a steep learning curve. Gahan’s father said, “We had no idea about type one diabetes.” But, like most families dealing with a new type 1 diagnosis, they were forced to learn quickly, test, trial and find their way through the complex maze of management.
Thanks to initiatives like Spare a Rose, the family did not have to worry about finding the money to pay for Gahan’s insulin and supplies. The program manager at the center said, “Because of the very low income of his parents it would be very difficult for Gahan to manage his diabetes without the support of Life for a Child. His father said that the support is like a blessing from God.”
Gahan attends the Life for a Child partner center every two months to collect his insulin and supplies and has regular checkups with the team there.
Gahan’s diagnosis means he will continue to need access to insulin and blood glucose testing supplies every day. Can you Spare a Rose this February to help make sure Life for a Child can provide him with reliable and consistent care?
Dr. Duarte has been practicing medicine for over 30 years, specializing in endocrinology for the majority of that time. Encouraged by her father, she decided to study medicine from the time she was a young girl. Part of the reason Dr. Duarte decided to go into endocrinology was because of the lack of specialists in the area.
She explains — “I dedicated myself to diabetes because of the lack of attention to this pathology in Bolivia. The Head of Endocrinology Service during my residency in Spain truly had a passion for diabetes education and also influenced my decision.”
Diabetes in Bolivia
The diabetes landscape in Bolivia is severely lacking in resources and education. Dr. Duarte told Beyond Type 1 that “health in general is very poorly cared for in our country. The government does not have clear health policies … and there is no official healthcare for people with diabetes. There are no educational resources — everything that is done related to diabetes education comes from professionals interested in the subject, volunteers, and the people with diabetes themselves. Everyone affected by Type 1 diabetes works truly hard and sacrifices a lot.”
The difficulty for people with Type 1 diabetes in Bolivia begins before they are diagnosed, and continues throughout their journey.
Missed diagnoses are common as local doctors aren’t adequately trained on recognizing the symptoms. Once properly diagnosed, patients and their families must resort to a few specialized professionals. There has been some improvement in the area, as there are now pediatric endocrinologists in at least three cities of Bolivia that previously did not have the specialists.
Dr. Duarte explained that “if you have resources, you must purchase insulin, self-management supplies and everything you need from the local pharmacies. If you have insurance, in addition to medical care and in some cases nutritional care you only receive NPH Insulin and Regular insulin; no insurance provides glucose meters or test strips. Those patients without resources rely on help from Life for a Child.”
In 2003, Dr Duarte co-founded Centro Vivir con Diabetes, a non-profit with the mission to provide comprehensive, up-to-date, quality care and education to everyone with diabetes who requires it, whatever their social or economic situation.
Dr. Duarte told Beyond Type 1 how their partnership with Life For a Child has literally saved lives: “If it did not exist, many children who have diabetes would have just died. There are many parents who do not have the resources to sustain a chronic pathology that requires daily administration of insulin. Even if the children have access to insulin, most of them would not have access to a glucometer and test strips for daily testing. This program is life or death for many Bolivian children with Type 1.”
One such child facing the possibility of death was Brandon Miguel, who began showing the tell-tale symptoms of T1D when he was five years old. Brandon’s mom recalls “…my son was dying, [he] couldn’t walk… he didn’t eat, he did nothing. I had to carry him in my arms… he couldn’t move by himself.” Even after he was diagnosed, Brandon was put on a limited amount of insulin and was still not showing signs of improvement. That’s when Dr. Duarte and Life for a Child got involved.
Dr. Duarte remembers her first encounter with Brandon — “The most shocking thing at that time was to see that the lancets they used to test the blood from Brandon’s little fingers. They were old lancets that were so traumatic that cut instead of puncturing, the child was totally sore and did not let them continue testing. We provided very thin and more appropriate lancets, which in fact were a comfort for the child and a relief for his parents.”
Hope for the future
“I hope, with all my heart, that there will come a time when science will discover a total cure for diabetes and that when that moment comes, our children and youth with diabetes from all over the world can benefit from this cure without complications in their young organisms. That would be truly exciting.” – Dr. Elizabeth Duarte
This profile was originally published on Beyond Type 1