ESPE Abstracts

Background: In 2022, 1.52 million children and adolescents worldwide were diagnosed with type 1 diabetes mellitus (T1DM). During COVID-19, diabetic ketoacidosis (DKA) episodes in newly-onset and established cases increased in 44.2% and 30.1% of paediatric diabetes centres, respectively. In 2017-2019, 1,249 children were diagnosed with T1DM in Indonesia, and 70% were diagnosed with DKA at diagnosis in 2017. Changing Diabetes in Children (CDiC) is a public-private partnership (PPP) to enhance healthcare access for young people with T1DM in low-resource settings. Indonesia is a member of CDiC among 26 countries. Under the government-to-government partnership between Ministry of Health of Republic of Indonesia, Indonesia Pediatric Society, and Denmark, CDiC Indonesia is a non-profit organisation undertaking initiatives to improve patient registry, patient knowledge and skills, healthcare professionals (HCPs), and diabetes centres' capacity.

Methods: CDiC Indonesia's activities from 2021 to 2025 include: (1) Strengthening T1DM patient registry and diagnosis, using an application-based patient registry and distributing free glucometer and blood glucose (BG) strip tests for patients; (2) Patients and caregivers education; (3) Training HCPs for delivering high-quality paediatric T1DM care; and (4) Supporting the strengthening and establishment of paediatric diabetes centres.

Results: Per 19 June 2023, CDiC Indonesia has registered 981 T1DM children with a median(IQR) age of 12(6) years. They have received free glucometers or BG strips four times daily from CDiC. Seminars and workshops were attended by 1,528 children and adolescents with T1DM and their caregivers through 25 and two face-to-face and online sessions organised by CDiC Indonesia since November 2021. Online T1DM education for patients, caregivers and HCPs has generated over 7,200 engagements across Zoom and Instagram by March 2023. 3,482 HCPs consisting of paediatric endocrinologists, paediatricians, general practitioners, nurses, and dietitians have been trained through ten and six online and face-to-face seminars and workshops about T1DM care. Five paediatric diabetes clinics in Lampung, Medan, Jember, Banten, and Aceh were established between August 2022 and March 2023. Alongside with clinics' establishment, 848 HCPs were trained for T1DM care, and 113 new patients were recorded.

Conclusions: Established in 2021, the PPP of CDiC Indonesia has addressed barriers to healthcare access among children and adolescents with T1DM in Indonesia. Young patients with T1DM and their caregivers have received specialised education sessions and free BG monitoring kits, which the national health insurance scheme or programs have not provided. This partnership is also central to improving supply-side healthcare capacity for children and adolescents with T1DM.