What is Type 1 Diabetes?
A lot of people are unaware of this condition and surprised to know that there could be children needing life long insulin for survival. This type of diabetes affects predominantly young children between the ages of 1-15 years of age. If unrecognised, these children present with diabetic coma and die without proper treatment. In this condition, the child’s own blood cells think that the insulin producing beta cells in the pancreas are enemies and start to attach it by producing antibodies. https://www.youtube.com/watch?v=_OOWhuC_9Lw. These antibodies completely destroy the beta cells and therefore no insulin is produced. The blood glucose levels increase dangerously. The initial symptoms in children are drinking excessive water, passing lot of urine, bedwetting, loss of weight and feeling tired all the time. If unrecognised, most of the children present with a very dangerous medical condition called diabetic ketoacidosis, which can cause death if untreated or poorly treated. The great news is that early identification and prompt treatment with insulin saves lives. These children can normal healthy lives but need to be on lifelong insulin. usually four times a day of injections, which by itself is a huge strain on families. Adding to this is the economic implications for poor families, costing Rs 2500- Rs 3000/ month in addition to huge admission costs as in-patients if they end up with complications
Current burden of Type 1 diabetes in Tamilnadu & India:
Contrary to popular belief, India has an estimated 100000 children with type 1 diabetes . There is a trend of increasing incidence at a rate of 3-5 % every year in India. Our country accounts for most of the children with Type 1 diabetes in South East Asia. In our center at Kovai Medical Center & Hospital , we have nearly 250 children with type 1 diabetes. On an average, we have around 5 new cases/ month visiting or getting admitted to our center. In Coimbatore district alone, there should be nearly 750 children. Overall, we believe that there will be around 10,000 children at the minimum with type 1 diabetes in Tamilnadu alone. The bottom line is that type 1 diabetes is not an uncommon disorder casuing enormous strain on children and their families.
What does it mean for the child and parent to be told that their child has Type 1 diabetes?
- This means:
- Need for life long insulin injections for their child, mostly four injections/day
- Need for life long finger prick glucose testing atleast 2 times/ day
- Risk of major hospital admission if diabetes not properly controlled
- Financial impact for purchasing not only insulins but also consumables
- Huge psychological burden on the uncertainity of the course of disease
- Long term worries on future, education, marriage and the social stigma in India associated with insulin injections at a young age.
What is the real scenario in a poor family with a child diagnosed with Type 1 diabetes?
- Average income for the dad : Rs 8000
- Cost of one hospital admission with diabetes : Rs 1,00,000
- Cost of the best insulin for the child : Rs 2500/ month
- Cost of blood glucose testing for the child : Rs 500/ month
- Cost of mental anguish : No limits
- Cost of a child’s life : ?????
Why can’t families get insulins from Government Institutions free of cost?
- Long queues
- Only certain types of insulins available, may be unsuited to child needs
- Only in vials, not pen devices
- Suboptimal education and follow up
- Potential risk for frustrated parents to stop insulins and seek alternative medicines, which invariably results in death of child.