Setting up of Type 1 diabetes registry proposed
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The Type 1 Diabetic Welfare Society has called for setting up of a Type 1 diabetes registry to obtain accurate information about the burden of type 1 diabetes across Keralam. The recommendation has been made in ‘Kerala Comprehensive Type 1 Diabetes Care Programme,’ a State-level proposal for strengthening Type 1 diabetes care, that was submitted by the Type One Diabetic Welfare Society to Minister for Health and Family Welfare K. Muraleedharan.
The proposal points out that unlike Type 2 diabetes, Type 1 diabetes cannot be prevented just through diet, exercise, or lifestyle modification; priority must be given to early recognition, prompt insulin treatment, high-quality diabetes management, and access to modern monitoring and treatment technologies.
It talks about the impact the diagnosis of Type 1 diabetes can have on children as well as their parents. The realisation that their child will need insulin injections and continuous diabetes management for the rest of their life affects families emotionally, socially, educationally and financially. Government support should therefore be provided to children and their families so that a system is in place that allows children to learn, play, and grow while receiving uninterrupted diabetes care, says the proposal.
The proposal is built around four aspects -- essential medical support and modern diabetes technology; district Type 1 diabetes care and school safety; psychosocial, family and financial support; and early diagnosis, diabetic ketoacidosis (DKA) prevention, and continuity of care.
The first aspect is reliable access to rapid-acting analogue insulin and essential diabetes supplies such as pen needles, syringes, glucometers, and blood glucose test strips; routine laboratory monitoring; making continuous glucose monitors (CGM) available in a phased manner; and insulin pump/automated insulin delivery therapy. Establishment of a clear State-level eligibility and assessment pathway is mooted.
The proposal seeks setting up of a dedicated Type 1 diabetes clinic in every district in a phased manner. It also moots a State School Diabetes Safety Policy that allows among other things checking of blood glucose at schools, unrestricted use of CGM devices, facilities for insulin administration, and reasonable consideration during examinations, and emergency response protocols.
The third aspect is psychosocial and family support that includes counselling for children and parents, management of diabetes burnout, peer-to-peer support, financial assistance and social protection. Early identification of Type 1 diabetes, especially in primary healthcare facilities to prevent DKA; access to comprehensive health insurance; health ID card; and a dedicated 18+ transition care programme to ensure uninterrupted access to diabetes care once they become adults is the fourth aspect that the proposal focusses on.
The proposal, which contains an implementation roadmap, urges the government to strengthen and expand the Mittayi project into an integrated, sustainable, and State-wide Type 1 diabetes care system. It has been prepared on the basis of the Minister’s directions at an event a couple of months ago.
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