BSPED2021 Poster Presentations Diabetes (21 abstracts)
Government partnership working in Southeast Asia low-middle-income countries and Action4Diabetes improves Type 1 diabetes care
Sze May Ng 1,2 , Malene Iv 3 , Myint Nilar 4 , Khaysy Rassavong 5 , Chi Dung Vu 6 , Florence HS Tan 7 , Ngee Lek 8 & Charles Toomey 9
1University of Liverpool, Liverpool, United Kingdom; 2Southport and Ormskirk NHS Trust, Southport, United Kingdom; 3Kantha Bopha Children’s Hospital, Phnom Penh, Cambodia; 4Mandalay Children’s Hospital, Mandalay, Myanmar; 5Mahosot Hospital, Vientiane, Lao People’s Democratic Republic; 6Vietnam National Children’s Hospital, Hanoi, Vietnam; 7Sarawak General Hospital, Kuching, Malaysia; 8KK Women’s and Children’s Hospital, Singapore, Singapore; 9Action4Diabetes, Somerset, United Kingdom
Introduction: Globally, the main cause of mortality of type 1 diabetes (T1D) is lack insulin access. There is minimal data of health outcomes for T1D in low-middle-income countries (LMICs) in South-East Asia (SEA) where government funding of insulin and blood glucose monitoring kits either do not exist or is limited. Action4Diabetes (A4D) is a non-government organisation (NGO) initiated in 2016 and supports children and young people (CYP) with T1D in five countries -Laos, Malaysia, Vietnam, Cambodia and Myanmar in the SEA region. A4D is the only UK-registered NGO that provides comprehensive partnership programmes with local hospitals through a Memorandum of Understanding (MOU) with the governments in Laos, Vietnam and Cambodia which guarantees ongoing supplies of free insulin, blood glucose meter kits, HbA1c tests and hospital emergency funds.
Objectives: The objective is to determine the Hba1c outcomes in the five SEA countries between 2020-2021 through A4D partnership working with local government hospitals.
Methods: We reviewed with local healthcare professionals the latest HbA1c of 383 CYP with T1D between 2020 to 2021 who remained active in the A4D programme. The duration of support by A4D for these patients ranged from 3 to 60 months. Patients were excluded if they were lost to follow up or had died.
| Country | No. of Type 1 patients (n=383) | *Mean Age in years (range) | HbA1c mmol/mol (%) between 2020-2021 |
| Myanmar | 80 | 11.1 (1,17) | 67 (8.3) |
| Laos | 45 | 13.3 (3, 24) | 69 (8.4) |
| Vietnam | 48 | 9.7 (3,17) | 79 (9.4) |
| Cambodia | 181 | 17.9 (8, 29) | 95 (10.8) |
| Malaysia | 29 | 14.7 (4,26) | 82 (9.6) |
| Summary | 383 | 14.7 (1,29) | 83 (9.7) |
| *this represents the mean age (range-minimum, maximum)) of current active patients recruited to the A4D programme in 2020-2021 | |||
Conclusions: The average HbA1c of CYP with T1D under the A4D programme within the five SEA countries was high at 83 mmol/mol (9.7%). In many low-to-middle income countries, lack of infrastructure and universal health coverage adversely affect T1D outcomes. A4D partnering with local government to support CYP with T1D from diagnosis to adulthood is the first step to improving T1D outcomes in SEA.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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