ESPE Yearbook of Paediatric Endocrinology

Pediatr Diabetes. 2021;1–7. doi: 10.1111/pedi.13191

– The development of an awareness campaign and of a prospective registry in Mali enabled the collection of more accurate data on the incidence, prevalence and mortality of Type 1 diabetes (T1D) in children and youth <25 years– T1D incidence rose from 0.12 in 2007 to 0.74 in 2016 and T1D prevalence from 0.43 in 2007 to 2.90 in 2016 (per 100 000 population/years)– The registry improved the determination of true incidence and allowed for better care, reflected in the increase in prevalence

Type 1 diabetes (T1D) was once considered a rare disease in Sub Saharan African youth. It is now clear that T1D is not uncommon but that its diagnosis is often missed. Santé Diabète is an NGO that works in close partnership with the Malian Ministry of Health to ensure that medical care and diabetes education is provided, and with Life for a Child (LFAC) which supports the patients with free insulin, syringes, test strips, HbA1c testing and education resources. The 5-fold increase in the incidence and 7-fold increase in the prevalence of T1D observed in Mali between 2007 and 2016 show not only that prior to 2007, many cases of diabetes were misdiagnosed, but also that the registry leads to management of the newly diagnosed patients. This study also demonstrates the importance of collaboration between various stakeholders to ensure that diagnosis, management and access to insulin and to blood glucose monitoring become available even in Mali, one of the poorest countries in the world (Mali is a low-income country that ranked 170/192 in gross national income per capita in 2019).