Small idea, big difference

An eight-year-old child whose father is a migrant labourer from Bihar was diagnosed with type 1 diabetes and referred to the Delhi Diabetic Forum (DDF), a Delhi-based non-governmental organization working in the field of diabetes. Type 1 diabetes is a chronic disease in which there are high levels of sugar (glucose) in the blood. It can be fatal unless treated with insulin regularly. The child’s family was unable to afford the daily dose of insulin injections. The doctors at DDF evaluated his case and he was among the first few to receive free insulin under a scheme the NGO launched in April with the help of BD (Becton, Dickinson and Company), a medical technology firm.

Two decades ago, in 1991, a group of doctors from Delhi concerned about the growing number of diabetics formed the DDF with the aim of curtailing the spread of diabetes and making the life of diabetics easier. “As per WHO (World Health Organization) estimates, India has the maximum number of people with diabetes in the world. It is an alarming situation for India particularly because the largest increase is among young adults," says Rajiv Gupta, a Delhi-based diabetologist and chief adviser, DDF.

Alarming: India has the highest number of diabetics.

The DDF has been organizing diabetes camps every Sunday in Delhi, Noida and Gurgaon at five-six fixed places. They conduct free blood sugar testing and consultation and impart diabetes-related education to patients. Poor patients can take advantage of these free camps—the eight-year-old boy mentioned approached the DDF at one such camp.

The novel approach

The DDF’s work is cut out clearly: screening populations for the prevalence of diabetes; increasing awareness and imparting education about the disease (the International Diabetes Federation’s fifth edition of the Diabetes Atlas unveiled in November estimates that as many as 183 million people in the world are unaware that they have diabetes); undertaking research projects; and most importantly, mobilizing society, the corporate sector, the medical fraternity and government organizations to be more sensitive to diabetes. On 1 April, the DDF launched a free insulin project—a one-year programme to provide free insulin to poor children with type 1 diabetes. It is the organization’s most ambitious project yet.

A special team was put together to ensure the smooth running of the initiative and to maximize the availability of insulin to children from economically weaker sections. BD, a leading manufacturer of insulin syringes worldwide, gave a grant of 3 lakh and Biocon pledged to provide insulin at a subsidized cost. In addition, DDF funds too will be used for this. The average cost of insulin administration is 80-160 per day. “Twelve children have already benefitted and the target for this year is 200 children," says S.K. Wangnoo, senior consultant endocrinologist and diabetologist, Apollo Centre for Obesity, Diabetes and Endocrinology (Acode), Indraprastha Apollo Hospital, Delhi.

This is how they function: “A team of diabetologists from Delhi hospitals such as Lok Nayak Hospital, Indraprastha Apollo Hospitals and the DDF board of management scrutinizes the applications and decides the recipients. Subsequently a visit is made to the patient’s home and the treating doctor to ensure compliance and timely delivery of insulin," explains Dr Gupta. “These children are followed in respective diabetes clinics by their diabetic experts and are provided insulin free of cost by the DDF. The insulin is provided directly by the manufacturers through their sales representative at the doorstep of the patient. The representative also collects the empty vials and supplies new vials on a continuous basis throughout the year. The bill for the insulin supplied is paid by DDF after due verification," adds Dr Wangnoo.

The challenges

Currently the DDF has a one-year cap on the programme; it’s looking for more sponsors and donors to keep the programme going. “Besides cost, there are many challenges for acceptance of insulin therapy," says Dr Wangnoo. “Lack of education regarding the benefits of insulin therapy, social stigmas and the oft repeated notion (which of course is absolutely false) that insulin is the last stage of treatment are the issues we grapple with all the time. This is where diabetes education comes in handy. DDF works hard in this field too."

“But even small achievements help us take the work forward and tell us that we are on the right track," says Dr Wangnoo.

The Small idea, big difference series looks at socially relevant health problems and seeks to suggest solutions.

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