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Childhood and Youth Onset Diabetes in India: 69
Profile, Changes, Progress and Future ?

biological options like pancreatic or islet cell trans- 6. Societal, emotional, financial, and other support
plants cannot. More accurate testing for A1C, lipid is needed periodically.
levels, microalbuminuria, etc., including point of care 7. Regular monitoring of A1C, growth and puberty,
(POC) testing, and widespread availability of tests co-morbidities and chronic complications is es-
such as TSH and transglutaminase, have made long sential.
term monitoring easier.
8. Technology and awareness are improving: the
Teams and individuals providing focused care to chil- challenges can be met by patients, families, HCP,
dren and youth with diabetes are gradually increasing charitable organizations, and society at large,
in number, particularly in urban areas. The greater working together.
availability of pediatric endocrinologists, diabetolo-
gists with special interest in pediatric diabetes, and a REFERENCES
few diabetes educators, dieticians and psychologists 1. IDF Diabetes Atlas, seventh edition, 2015. Page 14.
trained in pediatric diabetes, is changing the lives
of those who can reach them. Self-help groups are 2. Danne T, Bangstad H-J, Deeb L, Jarosz-Chobot P, Mungaie L, Saboo B,
playing an increasing role in providing psychological, Urakami T, Battelino T, Hanas R. Insulin treatment in children and
adolescents with diabetes. Pediatric Diabetes 2014: 15 (Suppl. 20):
social and financial support to each other, in person 115–134
or through social media; and reducing costs by bulk 3. Ranabir S. Managing type 1 diabetes in remote and challenging locations
purchases or charity. Information is more freely avail- in India. Indian J Endocr Metab 2015; 19, Suppl S1: 29-30.
able in the most remote of areas, on the internet – to
HCP, and to patients and families, especially Guide- 4. Tandon N, Kalra S, Balhara YPS, Baruah MP, Chadha C, Chandalia HP, et
al. Forum for Injection Technique and Therapy Expert Recommendations,
lines from respected organizations like the Interna- India: The Indian Recommendations for Best Practice in Insulin Injection
tional Society for Pediatric and Adolescent Diabetes Technique, 2017. Indian J Endocr Metab 2017; 21 (4): 600-617.
(ISPAD), Indian Society for Pediatric and Adolescent 5. Virmani A. Growth disorders in type 1 diabetes: an Indian experience.
Endocrinology (ISPAE) and the American Diabetes Indian J Endocr Metab 2015; 19, Suppl S1: 64-67.
Association (ADA). 6. Virmani A. Safe disposal of used sharp objects. Indian Pediatr 2009;
46: 539.
Extensive research by different agencies is exploring
a wide variety of aspects, including prevention of T1D, 7. Puri S, Vedwal AK, Virmani A. A study of health seeking behavior in
better insulins (including oral or inhaled insulin) and families of children with type 1 diabetes. Indian J Endocr Metab 2016;
Abstracts, 21: 75.
other drugs, better devices (including pumps with in-
sulin and glucagon or insulin and pramlintide), islet 8. Standards of Medical Care in Diabetes 2017. Diabetes Care 2017;40(Sup-
pl. 1): S105–S113.
cell and pancreatic transplantation.
In summary, the scenario faced by a child with T1D
is daunting, but improving.

HIGHLIGHTS
1. Pediatric diabetes poses several challenges and
high medical, psychosocial and financial burden,
especially in resource constrained and remote
environments where supplies and specialized
team members may not be available.
2. Health care personnel should be well versed in
pediatric diabetes care, and provide correct dia-
betes education.
3. Appropriate multidose insulin regimens must be
advised, based on self blood glucose monitoring.
4. Insulin availability, correct storage and transport,
and availability of adequate glucostrips is crucial.
5. Unnecessary dietary and other restrictions can
cause harm and must be avoided.

Cardio Diabetes Medicine