ESPE Abstracts

Introduction: Action 4 Diabetes (A4D) is a UK non-profit organisation which has been providing free insulin and self-monitoring blood glucose test kits for children and young people (CYP) with type 1 diabetes (T1D) in Cambodia’s 2 large tertiary hospitals-Kantha Bopha II Hospital based in Phnom Penh (KB2H) and Jayavarman VII Hospital based in Siem Reap (J7H), since July 2018 and January 2020, respectively.

Objective: To report the glycated haemoglobin outcomes of T1D patients in the two hospitals stratified by insulin treatment regimen, namely, twice daily injections using self-mixed short- and long-acting insulin (BD); and basal-bolus multiple daily insulin injections (MDI).

Methods: Data on gender, current age, HbA1c at enrolment and during follow up in A4D clinical support programme, were reviewed.

Results: A total of 263 patients (109 male; 41%) were supported by A4D by December 2021. Mean age of patients in KBH2 on self mixed BD regimen was 16.6 years vs 17.4 years for MDI regimen. Mean age of patients in J7H on self mixed BD regimen was 14.5 years vs 18.1 years for MDI regimen. On average, the patients in KB2H were 1.4 years older than those in J7H In both hospitals, the patients on MDI were older than those on BD treatment. Overall glycaemic control did not differ by insulin regimen, and was suboptimal with mean HbA1c >10% (>86 mmol/mol) between 2019 to 2021, except for those on MDI in KB2H during 2020. In KB2H, mean HbA1c did improve marginally during follow-up, but not in J7H where the mean HbA1c during follow-up was similar to the mean HbA1c at enrolment.

Conclusion: The glycated haemoglobin outcomes in the patients with T1D in these two hospitals in Cambodia were suboptimal regardless of the insulin treatment regimen. The findings in this study suggest that in addition to providing insulin and blood glucose test kits, there is urgent need to further provide support and education to families and people with T1D and upskill the local healthcare professionals in T1D management so that they can empower the patients and their caregivers to optimise self-management effectively on a daily basis.