In 2006, we established our diabetes care center at a large, charitable hospital, Ram Krishna Mission Hospital (RKM) in Haridwar, India. Prior to our intervention, no child with Type-1 Diabetes had ever survived beyond short period due to misdiagnosis, inadequate care or lack of access to insulin. We took the challenge of providing comprehensive diabetes management to barely literate, marginalized children using multiple daily insulin injections (MDI), carbohydrate count in their diet and diabetes self-management education (DSME). We provided free insulin glucometer and strips. The foundation of our program has been culturally and linguistically appropriate DSME, tailored to local literacy levels. We had to overcome multiple barriers, misconceptions, and a general aversion to the use of insulin. We trained a local team consisting of a physician, a diabetes educator, and a community worker.
By 2016, we had 120 children with T1D who were treated using MDI. They were living a normal life with control of A1c and without any significant complications. We published our results in “Journal of Diabetology, Feb 2016;1;1”. The results that we achieved in Haridwar were comparable to some of the clinics in USA.
In an effort to overcome stigma and to boost confidence among children with diabetes, we also started regular support group meetings. We then started PenPals United - an internet-based support group connecting children in India with diabetic children in USA.
We started diabetes education to the children and their families. We conducted classes and seminars for hospital staff and for local area physicians.
We started camps in hospital and in remote areas to screen for diabetes and other risk factors. Physicians, nurses and diabetes educators in training participated in out-reach program.
Realizing the critical need of diabetes education in India by professionally trained diabetes educators, in 2010 we established a Certified Diabetes Educator India (CDEI) program at the nursing school of RKM hospital in Vrindaban. Program received International Diabetes Federation (IDF) recognition. Certificate awarded to graduating nurses had the IDF stamp.
IDF recognition letter
IDF Recognized “Certified Diabetes Educator” Program
We conducted online and inhouse classes with teaching on patients. We provided intensive seminar with the participation of guest specialist.
In 2014, we published a diabetes educator book, “ Living the Sweet Life with Diabetes”. It is presently in its second edition in both English and Hindi. It is available on the website of the “Indian Society of Pediatric and Adolescent Endocrinology.” Please click on following links to read online...
Living the Sweet Life with Diabetes (English)
Living the Sweet Life with Diabetes (Hindi)
Affiliation of MSF program in India with Washington University(WU) in Saint Louis, USA: The program called, “ Global Health Scholars in Medicine”, residents at WU were assigned to work with us at RKM Haridwar. We received appreciation certificate by Washington University.
We started diabetes education to the children and their families. We conducted classes and seminars for hospital staff and for local area physicians.
We started camps in hospital and in remote areas to screen for diabetes and other risk factors. Physicians, nurses and diabetes educators in training participated in out-reach program.
All children in the program were provided with free supply of insulin, glucometer, and strips.A1c and screening for complication were also done free. Program was supported by the grant and supplies from International Diabetes Federation – Life for a Child, Insulin for Life (IFL-USA) and MSF.
