A Unique Government–NGO–Industry Partnership Care Model to Reduce Morbidity and Mortality Among Underprivileged Children With Type 1 Diabetes Mellitus in LMIC: A Pilot Study From Tamil Nadu, India

Abstract

Aim: To pilot a 1-year comprehensive type 1 diabetes mellitus program, assessing outcomes on glycemic control and diabetic ketoacidosis (DKA) admissions pre- and post-intervention in underprivileged children with type 1 diabetes mellitus from three selected Government Medical College Hospitals across Tamil Nadu state, through a Government–nongovernmental organization (NGO)–Industry partnership. Materials and Methods: A total of 214 children were identified through the hospital database. Highly focused diabetes mellitus and insulin education along with analog insulins in penfill cartridges in the basal-bolus regime, high quality 800 memory glucometers with 100 glucose strips per month, ultrafine needles, 24/7 telephone support, and monthly review were supported to all the children. Data on baseline characteristics, pre- and post-intervention glycosylated hemoglobin A1c (HbA1c), and DKA admissions were tabulated on Microsoft Excel, and the results were analyzed. Results: A 2.4% reduction in HbA1c and more than 90% reductions in DKA admissions were seen post-intervention compared with baseline. This can potentially translate to huge reductions in mortality and cost savings for all stakeholders. Conclusions: A combined Government–NGO–Industry partnership is the need of the hour to reduce morbidity and mortality associated with type 1 diabetes mellitus among underprivileged children in India. Our model has the potential to serve as a blueprint for type 1 diabetes mellitus care in low- and middle-income countries.

Keywords

• lmic; outcomes; type 1 diabetes mellitus