Treatment of children (or adults) with T1D involves at least 4 insulin injections per day with blood sugar testing before every injection which must be done life-long to survive. So, the treatment regimen includes a total of eight needle pricks required to control blood sugar optimally. The parents must inject the insulin dose based on blood sugar value, the type and amount of meal to be taken, and kind of activity anticipated/exercise over the next few hours. Despite this strict and stressful regimen, the glucose control in most of the children/adults remains far from optimal. There are persistent blood sugar fluctuations daily with frequent low and high sugars directly affecting the day-to-day work (schooling/physical activity etc). Due to poor sugar control over the long term, several complications can occur, including blindness, kidney failure, loss of sensation, hypertension, heart problems etc.
In India, the most crucial reason for the poor treatment and outcome of children/adults with T1D is the cost of treatment (INR 4,000-5,000/month) which is recurring and lifelong. A large number of parents with children having T1D at PGIMER are not able to afford treatment and develop issues of weak growth, repeated hospitalizations due to acute complications, poor school performance, personal and family stress, complications of diabetes at a very early age and rarely death due to inadequate/unaffordability of treatment.