Global Inequality in Type 1 Diabetes: a Comparison of Switzerland and Low-and Middle-Income Countries

Nilson Almeida Marques; Maria Lazo-Porras; Valérie Schwitzgebel; Montserrat Castellsague; Georges Cimarelli; Mirjam Dirlewanger; Philippe Klee; Luz Perrenoud; David Beran

doi:10.17458/per.vol17.2020.mps.type1diabetescomparison

Global Inequality in Type 1 Diabetes: a Comparison of Switzerland and Low-and Middle-Income Countries

Pediatr Endocrinol Rev. 2020 Mar;17(Suppl 1):210-219. doi: 10.17458/per.vol17.2020.mps.type1diabetescomparison.

Authors

Nilson Almeida Marques¹, Maria Lazo-Porras², Valérie Schwitzgebel³, Montserrat Castellsague⁴, Georges Cimarelli⁵, Mirjam Dirlewanger⁶, Philippe Klee⁷, Luz Perrenoud⁵, David Beran⁸

Affiliations

¹ Faculty of Medicine, University of Geneva, Geneva Switzerland.
² Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland, 3CRONICAS Centre of Excellence in Chronic Diseases at Universidad Peruana Cayetano Heredia, Lima, Peru.
³ Pediatric Endocrine and Diabetes Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Diabetes Center of the Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland, E-mail: valerie.schwitzgebel@unige.ch.
⁴ Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland, Care Directorate, and Division of Tropical and Humanitarian Medicine, University Hospitals of Geneva, Geneva, Switzerland.
⁵ Care Directorate, and Division of Tropical and Humanitarian Medicine, University Hospitals of Geneva, Geneva, Switzerland.
⁶ Pediatric Endocrine and Diabetes Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.
⁷ Pediatric Endocrine and Diabetes Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland, Diabetes Center, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
⁸ Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland, Diabetes Center, Faculty of Medicine, University of Geneva, Geneva, Switzerland.

PMID: 32208565
DOI: 10.17458/per.vol17.2020.mps.type1diabetescomparison

Abstract

Globally it is estimated that over 1 million children and adolescents have Type 1 diabetes with large variations in incidence between different contexts. Health systems need to provide a variety of elements to ensure appropriate diabetes care, such as service delivery; healthcare workforce; information; medical products and technologies; financing and leadership and governance. Describing these elements between Geneva, Switzerland, a high-income country with high spending on healthcare and a large density of doctors, and low- and middle-income countries this article aims to highlight the global inequality of diabetes care. Type 1 diabetes can serve as a litmus as we move towards the centenary of the discovery of insulin and beyond as there is a need for a global movement to ensure that innovation in the management of diabetes benefits the whole diabetes community and not just a select few.

Keywords: Access; Insulin; Type 1 diabetes.

Publication types

Comparative Study

MeSH terms

Delivery of Health Care
Developing Countries
Diabetes Mellitus, Type 1*
Global Health
Humans
Socioeconomic Factors
Switzerland