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The IDF Life for a Child Program Index of diabetes care for children and youth
Graham D Ogle1,2, Angela C Middlehurst1,2, Martin Silink1,3
1International Diabetes Federation Life for a Child Program, Glebe, New South Wales, Australia.
Insights
Global diabetes care for youth shows significant disparities. A new index reveals that access to essential treatments like insulin and glucose monitoring strongly correlates with a nation's economic status, highlighting inequities in pediatric diabetes management.
Area of Science:
- Pediatric Endocrinology
- Global Health Disparities
- Diabetes Management
Background:
- Childhood diabetes care varies significantly worldwide.
- Developing standardized measures is crucial for comparing treatment outcomes.
- Existing care models lack global comparability.
Purpose of the Study:
- To develop and validate a standardized, reproducible measure for assessing pediatric diabetes care.
- To document and compare critical factors influencing treatment outcomes globally.
- To identify disparities in care for children and youth with diabetes.
Main Methods:
- A 36-question multiple-choice questionnaire was distributed to 75 countries.
- The survey covered key components of diabetes care, including insulin therapy and glucose monitoring.
- Country-specific results were standardized to a 0-100 score.
Main Results:
- Responses were received from 71 countries, showing wide score variations.
- Scores strongly correlated with per capita GDP and health expenditure (R²=0.72 and R²=0.77, respectively).
- Low-income countries faced significant gaps in insulin, test strips, refrigeration, advanced monitoring, and complication screening.
Conclusions:
- The developed index is a comprehensive and easily administered survey tool.
- Stark differences in access to essential diabetes care components were identified.
- Economic factors significantly impact the availability of necessary resources for pediatric diabetes management.
Background And Objectives:
Care for children and youth with diabetes varies markedly around the world. We developed a standardized, reproducible measure that can be used to document and compare critical factors influencing treatment outcomes.
Methods:
A questionnaire consisting of 36 multiple-choice questions covering major components of care (such as insulin therapy, blood glucose monitoring, etc.) was sent to 75 countries: 43 under-resourced countries where the International Diabetes Federation's Life for a Child Program operates, and 32 others (mainly developed nations). Results for each country were scaled to a score with a range of 0-100.
Results:
Responses were received from 71 countries. Scores varied widely and were highly correlated to per capita gross domestic product (R(2) = 0.72, P < 0.001) and health expenditure (R(2) = 0.77, P < 0.001). For the 37 low- and lower-middle income countries, only two had complete government provision of human insulin and none of blood glucose test strips. Marked differences according to income were also found for access to home refrigeration; usage of insulin pens, multiple daily injections, pumps, glucagon and ketone strips; hemoglobin A1c (HbA1c) testing; and complications screening.
Conclusions:
The index is a comprehensive, easily administered survey instrument. It demonstrated stark differences in access to numerous components of care necessary in achieving good outcomes for children and youth with diabetes.
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