Physicians have appealed to the government to evolve a financial aid scheme for the treatment of children with Type 1 diabetes.

Children having Type 1 diabetes require a lifetime's supply of insulin, the expense of which is unaffordable for most parents.

“The government has introduced many welfare schemes now to help families with the medical expenses of children with serious illnesses. But children with Type I diabetes are not included in this group, even though their illness is chronic and requires specialised management using insulin throughout their life,” K.P. Poulose, former Professor of Medicine, Government Medical College Hospital, said.

From a public health perspective, the focus has always been on the management and control of Type 2 diabetes. However, Type 1 diabetes is not predictable or preventable and insulin shots are the key to day-to-day living.

“Those with Type 1 diabetes constitute only about 1 per cent of the population and thus their total number will be less that 50,000 in the State and still lesser in the BPL category. It should not be a huge burden for the government to provide free insulin to these children till they are 18-20 years old,” Dr. Poulose said.

After one eats food, the glucose levels in the blood go up, inducing the pancreas to produce the hormone insulin, which in turn allows the glucose to get into the cells. Diabetes results when the body cannot produce insulin or cannot respond to the insulin produced by the pancreas.

In Type 2 diabetes, the body cannot respond to the insulin it produces. However, in Type 1, the pancreas do not have to ability to produce insulin as the person's own immune system attacks and destroys the pancreatic cells that produce insulin.

The daily regimen of blood sugar monitoring and giving insulin shots to children and the constant worry over their children takes quite a toll on parents.

More than anything, they have to deal with the huge recurring expense of insulin and glucometer strips. In the West, insulin pumps that release the measured amounts of insulin into the bloodstream, are the preferred mode of treatment for Type 1 diabetes. However, this is not feasible in low-resource settings.

A child requires a minimum of 30 to 40 units of insulin a day and the monthly expense for this could be around Rs.600 a month. Regular glucose monitoring using glucometer strips and so on will involve additional money. However, for the BPL category at least, the government should be able to meet the monthly expense of insulin, it was felt.

Every child's insulin requirements or diet plans are different and it takes a lot of training before the child comes to terms with his or her disease and the parents learn how to manage the child's insulin and diet plan.

Dr. Poulose said lack of awareness of the disease and the absence of a proper school health system were the other major problems.

“Every school should form health squads by including parents, teachers and at least one doctor who should have a clear idea about the number of children with Type 1 diabetes in their school.

Special training should be given to selected teachers to take care of these children as they may suffer from hypoglycaemic (low blood sugar levels) episodes,” he said.

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