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Chapter 23: Limited Care Guidance Appendix
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Dear Members,
Dear Friends
 
Great disparities exist in the level of pediatric diabetes care available to children, resulting from a wide range of factors across the world, from huge imbalances of geographic, economic, and scientific development to gender discrimination. Limited access to insulin, food and supplies, limited access to care, financial burdens, psychosocial instability, and detrimental health beliefs can all contribute to suboptimal care of children with diabetes across the world. For all children with diabetes, the importance of providing a good start with clear, positive messages, support, and advice cannot be over-emphasized. In these settings it is imperative to establish, as early as possible, a systematic register of patients, demographics, and treatment records. Such data is vital in defining the problem and needs of this population to effectively advocate for these patients and their families.

More than half of the world's population is poor or extremely poor, and in large parts of the world, medical care is predominantly an out-of-pocket expense. Diabetes is an expensive condition to manage, and cost of diabetes care may be prohibitive without external support, for example, government support or health insurance. Availability of insulin and diabetes supplies, such as insulin syringes, glucose meters, and glucose and ketone test strips, may be quite limited, particularly in remote areas. This ISPAD chapter “Chapter 23: Limited Care Guidance Appendix” focuses on the most important aspects of diabetes care and highlights the priorities in less-privileged settings. See the chapter here and read the brief introduction to this Appendix here.
Check the presentation from Francois Bonnici: Societal Impact of Diabetes Resourcing diabetes care in low and middle income countries and figure out how to adapt and implement clinical guidelines in developing countries by Graham Ogle (Life for a Child – lfacinternational.org).


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© 2019 International Society for Pediatric and Adolescent Diabetes (ISPAD)

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