The Charter looks at epidemiology, organisation and delivery of care, as well as the psychosocial and the socio-economic impact of diabetes and provides a solid platform for strategies to improve the care and prevention of diabetes.

The Charter highlights that childhood diabetes is growing alarmingly worldwide. Over 70,000 children develop type 1 diabetes every year and the incidence is rising at a rate of 3% per year, with more children under the age of four being diagnosed.[1]

The publication stresses that while not enough data is available, it is now recognised that type 2 diabetes in children and adolescents is also on the rise and affects children in both developed and developing countries. For instance, Western Australia had an increase of 27% in the incidence of type 2 diabetes in young people between 1990 and 2002, and also Japan has experienced the same development with a more than 30-fold increase over the past 20 years. Both increases are believed to be a result of overweight and increasing obesity rates.[2]

As the rate of childhood diabetes is going up, the Charter provides a picture that much could be done to prevent complications of diabetes. Not just in countries with limited access to care, but also in many developed countries. For instance, of children with type 1 diabetes studied in France, only one in seven were at the American Diabetes Association (ADA) target of mean glucose levels under 7%. Since the risk of complications is linked to glycaemic control, stricter control is recommended. The complications of diabetes can be very severe, leading to early onset of cardiovascular disease and premature death.

“More has to be done to diagnose diabetes in children in a timely manner and give them adequate diabetes care. However, for many children, particularly in the less-developed world, the diagnosis of diabetes is still a death sentence. The family simply does not have money to allow their child to be treated with insulin and thereby save the child’s life. Even in the developed countries, children with diabetes in poor control live 10–20 years shorter than their peers,” says Dr Henk-Jan Aanstoot, chair of the Diabetes Youth Charter.

The Charter highlights a number of actions to promote better outcomes in childhood diabetes:

• Type 2 diabetes can be prevented in children through lifestyle changes, including better nutrition and physical exercise.

• Early detection, intensive treatment and improved care strategies may prevent complications and add years to life. Diabetes self-management education for every child and their family is necessary to achieve appropriate regulation of the disease.

• The changing epidemiological patterns in type 1 and type 2 diabetes among children create major knowledge gaps concerning the impact of diabetes and how to manage it. We need to understand the epidemiology better to facilitate effective treatment and care strategies and optimal resource allocation and organisation.

• While there is great variation in the availability of insulin around the world, some of the least developed countries have managed to provide a basic standard of care. Fiji and Azerbaijan are examples of countries that have succeeded in providing insulin to every child requiring it. Partnerships should be established to help the world’s least developed countries develop sustainable solutions for treating children with diabetes.

Lise Kingo, executive vice president of Novo Nordisk, stated “Novo Nordisk will explore how some of our existing programmes can be fine-tuned and strengthened to better reflect the challenges presented in the Youth Charter. Specifically, we are working to create and test a new model for sustainable diabetes care and insulin delivery for children in the developing world. Starting in 2008, we will test the new model in a few countries, one of them being Tanzania. This endeavour will be done in close collaboration with our international and local partners.”

With the Charter, Novo Nordisk and IDF seek to motivate healthcare systems around the world to do more for children and adolescents living with diabetes, by securing access to medicine and treatment, but also by educating the people around each child to facilitate successful management of the condition.

IDF President Martin Silink stressed that “access to diabetes care, especially for children and adolescents, is a human right which should no longer be ignored. Action must be taken now to prevent the needless deaths of children in both developed and less-developed nations. Governments should prioritise childhood diabetes on a par with HIV/AIDS, tuberculosis and malaria”.

The Diabetes Youth Charter (The Global Burden of Youth Diabetes: Perspectives and Potential) has been prepared by some of the world’s leading paediatric diabetologists. The launch of the Diabetes Youth Charter follows the recent adoption of the UN Resolution on diabetes (Resolution 61/225) and supports the World Diabetes Day (WDD) theme for 2007 and 2008, ‘Diabetes in Children and Adolescents’. The first UN-observed WDD will be this year on 14 November.

The full version of the Diabetes Youth Charter is available online: blackwell-synergy.com/toc/pdi/8/s8.
For more information, please contact Markela Dedopoulos, PR & Media liaison manager at Novo Nordisk, mded@novonordisk.com, +45 3079 4137.