Availability and access to pediatric diabetes care: a global descriptive study.

Area of Science:

• Pediatric Endocrinology
• Global Health Equity
• Diabetes Management

Background:

• Type 1 diabetes mellitus (T1DM) prevalence is rising globally.
• Inequalities in essential T1DM care persist a decade after insulin's discovery.
• Specific details on insulin and medical device availability worldwide remain unclear.

Purpose of the Study:

• To investigate global access, availability, and affordability of pediatric T1DM care.
• To identify disparities in essential diabetes medications and medical devices.
• To assess patient financial responsibility for T1DM management.

Main Methods:

• A cross-sectional electronic survey was distributed globally via the International Pediatric Association (IPA).
• Standardized questions assessed pediatric diabetes care access and availability.
• Responses from 25 pediatric societies across six regions were analyzed.

Main Results:

• Pediatric endocrinologists, often with pediatricians or adult endocrinologists, manage T1DM care.
• 40% of patients bear partial/complete costs for insulin, with higher out-of-pocket expenses for A1C, C-peptide, and antibody testing.
• Government support is limited for insulin pumps (20%) and continuous glucose monitors (12%).

Conclusions:

• Considerable disparities exist in T1DM testing, medication, and support access, availability, and affordability.
• Significant out-of-pocket payments for care are common in many countries.
• Country- and region-specific national program improvements are crucial for optimal global pediatric T1DM care.