Fauzi Muhammad, Fadiana Ghaisani, Nadira Dhiya, Angela Angela, Puteri Helena Arnetta, Pulungan Aman
Department of Child Health, Universitas Airlangga - Dr. Soetomo General Hospital, Surabaya, Indonesia.
Indonesian Pediatric Society, Jakarta, Indonesia.
J Clin Res Pediatr Endocrinol. 2024 Nov 27. doi: 10.4274/jcrpe.galenos.2024.2024-9-4.
Type 1 Diabetes Mellitus (T1DM) is a chronic condition requiring lifelong management that affects a large number of children and adolescents globally. While diabetes care has improved over the years, low-middle income countries (LMIC) like Indonesia still struggle to achieve optimal diabetes care due to limited access to healthcare professionals, insulin, diabetes technologies, and self-monitoring blood glucose (SMBG) devices. Data from the Indonesian Pediatric Society registry has reflected a stark increase in the number of children with T1DM, with the current prevalence significantly concentrated on Java Island and a noticeable underreporting in rural regions. Another major challenge is the uneven distribution of pediatric endocrinologists, resulting in a low specialist-to-patient ratio. This imbalance, coupled with inadequate access to comprehensive diabetes care, complicates effective T1DM management. While the national insurance covers a portion of costs associated with T1DM care, vital aspects of T1DM management including SMBG devices are still not covered, resulting in significant financial burden to families. Access to diabetes technologies that improve glycemic control and quality of life of patients is also still largely limited. This paper evaluates the current state and future needs for insulin and SMBG in Indonesia, emphasizing the necessity of strategic interventions to improve access and quality of diabetes care.
1型糖尿病（T1DM）是一种需要终身管理的慢性疾病，全球有大量儿童和青少年受其影响。尽管多年来糖尿病护理有所改善，但像印度尼西亚这样的中低收入国家（LMIC），由于获得医疗保健专业人员、胰岛素、糖尿病技术和自我监测血糖（SMBG）设备的机会有限，仍难以实现最佳的糖尿病护理。印度尼西亚儿科学会登记处的数据显示，T1DM儿童数量急剧增加，目前的患病率显著集中在爪哇岛，农村地区报告明显不足。另一个主要挑战是儿科内分泌学家分布不均，导致专科医生与患者的比例较低。这种不平衡，再加上获得全面糖尿病护理的机会不足，使得T1DM的有效管理变得复杂。虽然国家保险涵盖了与T1DM护理相关的部分费用，但T1DM管理的重要方面，包括SMBG设备，仍然没有涵盖，给家庭带来了巨大的经济负担。获得能够改善患者血糖控制和生活质量的糖尿病技术的机会也仍然非常有限。本文评估了印度尼西亚胰岛素和SMBG的现状及未来需求，强调了采取战略干预措施以改善糖尿病护理的可及性和质量的必要性。
