Pediatric Type 1 Diabetes Care in Indonesia: A Review of Current Challenges and Practice

Area of Science:

• Pediatric Endocrinology
• Global Health
• Chronic Disease Management

Background:

• Type 1 Diabetes Mellitus (T1DM) is a global chronic condition affecting children and adolescents.
• Low-middle income countries, including Indonesia, face significant barriers to optimal T1DM care.
• Increasing T1DM prevalence in Indonesia, particularly on Java Island, with underreporting in rural areas.

Purpose of the Study:

• To evaluate the current status and future requirements for insulin and self-monitoring blood glucose (SMBG) in Indonesia.
• To highlight the challenges in accessing essential diabetes management tools and technologies.
• To emphasize the need for strategic interventions to enhance T1DM care quality and accessibility.

Main Methods:

• Analysis of data from the Indonesian Pediatric Society registry.
• Assessment of healthcare professional distribution, focusing on pediatric endocrinologists.
• Evaluation of access to insulin, diabetes technologies, and SMBG devices.
• Review of national insurance coverage for T1DM care components.

Main Results:

• Indonesia experiences a growing number of children with T1DM, with uneven geographical distribution.
• A critical shortage of pediatric endocrinologists leads to a low specialist-to-patient ratio.
• Limited access to and coverage of essential T1DM management tools, such as SMBG devices, imposes financial burdens on families.
• Access to advanced diabetes technologies for improved glycemic control remains restricted.

Conclusions:

• Urgent strategic interventions are necessary to address the disparities in T1DM care within Indonesia.
• Improving access to insulin, SMBG devices, and comprehensive diabetes technologies is vital for better patient outcomes.
• Addressing the uneven distribution of specialists and enhancing healthcare infrastructure are key to overcoming T1DM management challenges in Indonesia.