Research Topic

Childhood Diabetes in Low- and Middle-Income Countries: Progress, Challenges, and Actions Needed

About this Research Topic

The prevalence of childhood diabetes is increasing globally. Currently, the incidence of children with type 1 diabetes is increasing at a rate of 3% per year, and that of children with type 2 diabetes is also increasing rapidly with the growing global prevalence of obesity. The situation is more disturbing in low- and middle-income countries (LMICs) which are facing big challenges in disease prevention and control.
Firstly, with the social transformation and lifestyle changes, the prevalence of insulin resistance-related diseases such as obesity, metabolic syndrome, and polycystic ovary syndrome have increased dramatically. However, the reasons for the induction of insulin resistance, subsequent pancreatic islet failure, and eventual diagnosis of diabetes remain unclear. The epidemiological data and clinical characteristics of resistance-related diseases are unclear, and the diagnosis and treatment methods are limited. Further exploration is needed
Secondly, the level of development for different regions differ. LMICs have vast rural areas which means economic backwardness, different social and family priorities, limited medical resources, low primary care capabilities, low level of early recognition, assessment, treatment of and patient transfer service for diseases relevant to insulin resistance and childhood diabetes, and lack of simple and locally actionable assessment, diagnosis, and treatment strategies for children in critical conditions.
Thirdly, the insufficient resource access and insufficient health insurance coverage, including those for drugs, consumables, and blood glucose test strips required for treatment, together with the lack of necessary support from community and schools, etc., has led to commonly visible treatment compliance issues, for example no or insufficient blood glucose testing, and reduced availability of insulin. As such, prognosis is seriously affected.
Fourthly, insufficient public and parental awareness and shortage of medical professionals with expertise in diabetes have resulted in late medical consultation or lack of treatment, in-family management, and lack of professional guidance for the patients. Multiple forms of diabetes education and training for specialist healthcare staff are needed.
Lastly, with the rapid development and expansion of the internet, some LMICs have begun to explore using online platforms and mobile devices for diabetes education, management, and follow-up, and have achieved improved results.
Summarizing and sharing successes and failures will provide guidance to LMICs on further establishing and optimizing their management systems for diabetes and even other chronic diseases. This Research Topic will review the status quo of childhood diabetes in LMICs, including the latest research on clinical features, pathogenesis, treatment strategies, healthcare policies, and diabetes education, with the aim of clarifying future research priorities, promoting approaches and strategies which are suitable for prevention and control of childhood diabetes in LMICs, and increasing the knowledge of childhood diabetes among policy makers and the public.
We welcome original research, reviews, systematic reviews, perspectives, clinical practice guidelines, and case reports on:
- Basic and clinical research on insulin resistance related diseases
- Prevalence and risk factors of diabetes in children in LMICs
- Pathogenesis for of type 1 and 2 diabetes in children
- Blood glucose monitoring and prevention of complications in children with diabetes in LMICs
- Strategies adopted in primary care with regard to recognition, assessment, diagnosis, and patient transfer for critical childhood diabetes in LMICs
- The relationship between medical insurance coverage and prevention and control of childhood diabetes in LMICs
- Endeavours on the model and system of education for childhood diabetes (including those for family members, patients, schools, and professional staff) in LMICs
- Application of new technologies, such as artificial intelligence and internet, in prevention and control of childhood diabetes in LMICs

Conflict of Interest
Topic Editor Mitchell Eugene Geffner has a research contract from Novo Nordisk; is an advisory board member for Adrenas, Daiichi Sankyo, Ferring, Neurocrine Biosciences, Novo Nordisk, Nutritional Growth Solutions, Pfizer, QED, and Spruce Biosciences; is a member of data safety monitoring boards for Ascendis, Millendo, and Tolmar and receives royalties from McGraw-Hill and UpToDate.
Daiichi Sankyo, Novo Nordisk and Pfizer make diabetes products.


Keywords: childhood diabetes/pediatric diabetes, blood glucose monitoring, low- and middle-income countries (LMIC), prevention of complications, primary care, medical insurance coverage, artificial intelligence and internet, education, prevention and control


Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

The prevalence of childhood diabetes is increasing globally. Currently, the incidence of children with type 1 diabetes is increasing at a rate of 3% per year, and that of children with type 2 diabetes is also increasing rapidly with the growing global prevalence of obesity. The situation is more disturbing in low- and middle-income countries (LMICs) which are facing big challenges in disease prevention and control.
Firstly, with the social transformation and lifestyle changes, the prevalence of insulin resistance-related diseases such as obesity, metabolic syndrome, and polycystic ovary syndrome have increased dramatically. However, the reasons for the induction of insulin resistance, subsequent pancreatic islet failure, and eventual diagnosis of diabetes remain unclear. The epidemiological data and clinical characteristics of resistance-related diseases are unclear, and the diagnosis and treatment methods are limited. Further exploration is needed
Secondly, the level of development for different regions differ. LMICs have vast rural areas which means economic backwardness, different social and family priorities, limited medical resources, low primary care capabilities, low level of early recognition, assessment, treatment of and patient transfer service for diseases relevant to insulin resistance and childhood diabetes, and lack of simple and locally actionable assessment, diagnosis, and treatment strategies for children in critical conditions.
Thirdly, the insufficient resource access and insufficient health insurance coverage, including those for drugs, consumables, and blood glucose test strips required for treatment, together with the lack of necessary support from community and schools, etc., has led to commonly visible treatment compliance issues, for example no or insufficient blood glucose testing, and reduced availability of insulin. As such, prognosis is seriously affected.
Fourthly, insufficient public and parental awareness and shortage of medical professionals with expertise in diabetes have resulted in late medical consultation or lack of treatment, in-family management, and lack of professional guidance for the patients. Multiple forms of diabetes education and training for specialist healthcare staff are needed.
Lastly, with the rapid development and expansion of the internet, some LMICs have begun to explore using online platforms and mobile devices for diabetes education, management, and follow-up, and have achieved improved results.
Summarizing and sharing successes and failures will provide guidance to LMICs on further establishing and optimizing their management systems for diabetes and even other chronic diseases. This Research Topic will review the status quo of childhood diabetes in LMICs, including the latest research on clinical features, pathogenesis, treatment strategies, healthcare policies, and diabetes education, with the aim of clarifying future research priorities, promoting approaches and strategies which are suitable for prevention and control of childhood diabetes in LMICs, and increasing the knowledge of childhood diabetes among policy makers and the public.
We welcome original research, reviews, systematic reviews, perspectives, clinical practice guidelines, and case reports on:
- Basic and clinical research on insulin resistance related diseases
- Prevalence and risk factors of diabetes in children in LMICs
- Pathogenesis for of type 1 and 2 diabetes in children
- Blood glucose monitoring and prevention of complications in children with diabetes in LMICs
- Strategies adopted in primary care with regard to recognition, assessment, diagnosis, and patient transfer for critical childhood diabetes in LMICs
- The relationship between medical insurance coverage and prevention and control of childhood diabetes in LMICs
- Endeavours on the model and system of education for childhood diabetes (including those for family members, patients, schools, and professional staff) in LMICs
- Application of new technologies, such as artificial intelligence and internet, in prevention and control of childhood diabetes in LMICs

Conflict of Interest
Topic Editor Mitchell Eugene Geffner has a research contract from Novo Nordisk; is an advisory board member for Adrenas, Daiichi Sankyo, Ferring, Neurocrine Biosciences, Novo Nordisk, Nutritional Growth Solutions, Pfizer, QED, and Spruce Biosciences; is a member of data safety monitoring boards for Ascendis, Millendo, and Tolmar and receives royalties from McGraw-Hill and UpToDate.
Daiichi Sankyo, Novo Nordisk and Pfizer make diabetes products.


Keywords: childhood diabetes/pediatric diabetes, blood glucose monitoring, low- and middle-income countries (LMIC), prevention of complications, primary care, medical insurance coverage, artificial intelligence and internet, education, prevention and control


Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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Submission Deadlines

18 June 2020 Abstract
31 August 2020 Manuscript

Participating Journals

Manuscripts can be submitted to this Research Topic via the following journals:

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Topic Editors

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Submission Deadlines

18 June 2020 Abstract
31 August 2020 Manuscript

Participating Journals

Manuscripts can be submitted to this Research Topic via the following journals:

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