Integrated management of type 1 DM children WDF09-491

Integrated management of type 1 DM children WDF09-491

The aim of the project is to create an integrated system for management of children with type 1 diabetes.

Objectives & approach

The mortality rate of children with diabetes is high in developing countries. The life expectancy of a child diagnosed with diabetes 1 is typically low and in some cases the children die even before they are diagnosed. Similarly, children who survive into adulthood often experience early onset of complications due to poor management of their disease.
Before this project there was no diabetes clinic for children in Guinea and the health care system lacked capacity to deal with type 1 diabetes in children. This resulted in inadequate management and poor outcome for children with diabetes. This project, being implemented in Conakry, Labé and Kankan in the Republic of Guinea, seeks to change this picture, by developing an integrated system for management of the disease and thereby supports the UN Millennium Development Goal 4 of reducing child mortality.

The aim of the project is to create an integrated system for management of children with type 1 diabetes.

The project is being implemented within the framework of Guinea's national programme for the prevention and control of Non Communicable Diseases in the Republic of Guinea. The project is lead by Dr. Naby Moussa Balde, who also is responsible for another project focusing on improving access to and quality of diabetes care in Guinea Conakry (WDF07-284).

The "Hub and Spoke" approach will be used to implement this project to ensure better access to care for children with diabetes. Two other projects are already being implemented with the same approach and co-founders, namely WDF09-457 in Uganda and WDF09-459 in DR Congo.

Initially, two hubs in Conakry (one in the Department of Endocrinology and another in the Department of Paediatrics) will be established. These hubs will work as supervising clinics for two satellite centres established in two peripheral districts, namely Labé and Kankan. When the project is well established and functioning, more satellite centres will be set up - securing care for more children with diabetes. The clinics and centres will be established in already existing structures and will be equipped with appropriate equipment for laboratories and clinics.

The management of diabetes in children is challenging and is different from that of adult diabetes, which is is why eight doctors and sixteen nurses will receive training in childhood type 1 diabetes and its complications. This will take place in the newly established hubs and satellite centres. The training will be based on the IDF-ISPAD "Guidelines for comprehensive management of type 1 diabetes in children" adapted specifically to the Republic of Guinea and thereby ensuring a certain quality level of the staff. Training of the doctors and nurses will take place each year the project is running, starting with a three-day workshop the first year, a two-day refresher course the second year and a two-day consolidation course the final year of the project.

In order to improve the quality and maintain a high level of diabetes care and management for the children, a national diabetes registry will be established for children diagnosed with type 1 diabetes. The registry will ensure proper surveillance and follow-up of the children, making it possible to track the children. The clinics and centres will be provided with IT equipment and software for data collection and reporting. It is anticipated that 450 children will be enrolled in the clinics.

After establishment of hubs and spokes and training of the health care professionals, children with diabetes and their parents will be educated in diabetes self-management via diabetes camps and educational sessions at the centres. With the intention of giving the best education to children and their parents, existing education materials will be reviewed and adapted to children. Diabetes camps will also offer a forum for children to experience peer support. Peer support is expected to strengthen the children in self-management of their disease. These activities are expected to lead to a significant improvement of self-management and the quality of life for children with diabetes.

In 2009, Novo Nordisk A/S initiated a worldwide programme called Changing Diabetes in Children with the focus on improving the conditions for children with diabetes in the world's poorest countries. The World Diabetes Foundation funding will assist capacity building. The current project is a part of this programme, and children in the project will receive insulin and blood glucose monitoring devices and supplies free of charge. Furthermore, Roche Diagnostics Ltd will provide support for equipment and patient education.

Expected results 
•    4 diabetes clinics established
•    8 doctors trained
•    16 nurses trained
•    3 children camps conducted
•    450 children and their families educated in juvenile type 1 diabetes

Project information

Project nr.: 
Project Status: 
Interventions and focus areas: 
Primary focus area: 
Donka University Hospital (MoH)
Project responsible: 
Pr. Naby Moussa Baldé
Project period: 
Project budget: 
USD 642.095
WDF contribution: 
USD 117.975

Expected results 

  •  4 diabetes clinics established
  •  8 doctors trained
  • 16 nurses trained
  • 3 children camps conducted
  • 450 children and their families educated in juvenile type 1 diabetes