Access to diabetes treatment in northern Ethiopia.

Treatments for diabetes in Ethiopia are at present only available in hospitals so many patients must travel great distances to obtain insulin, tablets, and diabetes education. We reviewed all 496 people with diabetes attending the diabetic clinic at Gondar Hospital (281 with Type 1 (insulin-dependent) diabetes mellitus (DM) and 215 with Type 2 (non-insulin-dependent) DM. Half of the patients came from rural areas, all but 3 of them travelling more than 20 km, one-quarter of them more than 100 km and 33 patients (13%) more than 180 km. It is likely that many patients who fail to attend from the more distant areas have died. We are developing a scheme which would enable diabetic patients to be treated at rural health centres by nurses trained in the principles of diabetes care which could greatly improve the outlook for diabetic patients in Ethiopia.