Finding missing children with type 1 diabetes

How can Mexican non-profits locate and help thousands of children with #type1diabetes? That was the task recently set for me by an international diabetes charity that provides free insulin and blood glucose testing equipment to over 46,000 patients worldwide.

The group is currently helping almost 1,000 kids with Type 1 diabetes in Mexico. It secures supplies from a US-based company, and then works with Mexican diabetes associations to identify needy families, distribute blood test supplies, and track patients' progress.

There are roughly 12,000 additional children in Mexico who also need support. The international program

could help them all, but its Mexican partners will need to find the children first. The task is gargantuan, as there is no central registry of pediatric Type 1 patients at either the federal or state levels.

Once these children are identified, volunteer groups such as the Jalisco Diabetes Association in Guadalajara will need to deliver the supplies to individual families, train them to use the equipment, and then regularly liaise with their doctors to receive health updates.

Scaling a program's reach from one to 13,000 beneficiaries is a huge task! Last month, I traveled to Mexico City, Oaxaca and Sinaloa with the Mexican Diabetes Federation and its Jalisco affiliate to learn about the challenges.

To make this work, Mexican diabetes associations will have to advertise on social media, harass local officials, call individual doctors, and work the country's decentralized health bureaucracy to locate all those Type 1 kids. Only then can the painstaking work of shipping more supplies and training new patients begin.

Diabetes is increasingly prevalent in Mexico and the world, but over 90% of cases are of the Type 2 variant. The much rarer Type 1 is an autoimmune affliction in which the patient's pancreas ceases to produce insulin. Its incidence clusters in children and, hence, the disease's former name, "juvenile diabetes."

Without insulin, Type 1 patients will soon die. And without blood glucose testing equipment, it's hard to know how much insulin to inject several times a day, leading to all kinds of health complications, including impaired kidneys, nerves, and eyes.

Doctors tell Type 1 patients to perform at least four blood sugar tests each day, but the cost is prohibitive. A single test strip costs roughly 30 cents in Mexico, meaning that four daily checks would cost 36 dollars per month, a whopping 15% of the minimum Mexican wage. As a result, most kids with Type 1 do not regularly test their blood. Public health systems provide insulin in most cases, but they don't have a budget for blood sugar test strips.

If Mexican diabetes associations can locate more children with Type 1, they can help them with the internationally donated supplies.