Back to Search
Start Over
COVID-19 and type 1 diabetes: Challenges and actions
- Source :
- Diabetes Research and Clinical Practice
- Publication Year :
- 2020
- Publisher :
- Elsevier B.V., 2020.
-
Abstract
- Optimal care for children and adolescents with type 1 diabetes is well described in guidelines, such as those of the International Society for Pediatric and Adolescent Diabetes. High-income countries can usually provide this, but the cost of this care is generally prohibitive for lower-income countries. Indeed, in most of these countries, very little care is provided by government health systems, resulting in high mortality, and high complications rates in those who do survive. As lower-income countries work toward establishing guidelines-based care, it is helpful to describe the levels of care that are potentially affordable, cost-effective, and result in substantially improved clinical outcomes. We have developed a levels of care concept with three tiers: "minimal care," "intermediate care," and "comprehensive (guidelines-based) care." Each tier contains levels, which describe insulin and blood glucose monitoring regimens, requirements for hemoglobin A1c (HbA1c) testing, complications screening, diabetes education, and multidisciplinary care. The literature provides various examples at each tier, including from countries where the life for a child and the changing diabetes in children programs have assisted local diabetes centres to introduce intermediate care. Intra-clinic mean HbA1c levels range from 12.0% to 14.0% (108-130 mmol/mol) for the most basic level of minimal care, 8.0% to 9.5% (64-80 mmol/mol) for intermediate care, and 6.9% to 8.5% (52-69 mmol/mol) for comprehensive care. Countries with sufficient resources should provide comprehensive care, working to ensure that it is accessible by all in need, and that resulting HbA1c levels correspond with international recommendations. All other countries should provide Intermediate care, while working toward the provision of comprehensive care.
- Subjects :
- Coronavirus disease 2019 (COVID-19)
Adolescent
Endocrinology, Diabetes and Metabolism
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
medicine.medical_treatment
Pneumonia, Viral
Article
Diabetes Complications
Betacoronavirus
Endocrinology
Diabetes mellitus
Pandemic
Internal Medicine
medicine
Insulin
Humans
Child Care
Mortality
Child
Pandemics
Developing Countries
Poverty
Type 1 diabetes
biology
SARS-CoV-2
business.industry
Diabetes
COVID-19
General Medicine
Supply chain
medicine.disease
biology.organism_classification
Self-Care Units
Virology
Diabetes Mellitus, Type 1
Adolescent Health Services
Health Resources
Comprehensive Health Care
Coronavirus Infections
business
Intermediate Care Facilities
COVID 19
Subjects
Details
- Language :
- English
- ISSN :
- 18728227 and 01688227
- Volume :
- 166
- Database :
- OpenAIRE
- Journal :
- Diabetes Research and Clinical Practice
- Accession number :
- edsair.doi.dedup.....5003717f001805c76b32b3bb92fb40c0