James Elliott is convinced that the statistics describing the prevalence of type 1 diabetes are misleading. “People say that there is little or no type 1 diabetes in poor countries,” he says. “But that is because all of the people who had it are dead.” Elliott, a health researcher working with Doctors Without Borders/Médecins Sans Frontières and other organizations, has type 1 diabetes himself. As a volunteer advocate with the diabetes patient organization T1International, he and his colleagues confront the often-fatal problems caused by the price of insulin and other diabetes supplies. Elliott’s work recently took him to Cameroon, where a physician shared the story of a young patient’s father happily delivering news. “Did you hear?” the father said with a smile. “Isabelle died!” He was referring to his diabetic daughter (the name here is a pseudonym). The family had struggled to pay for her insulin and equipment, such as syringes and blood sugar test strips. Uneven access to the medicine had often left the young girl quite ill, and its cost when it was purchased had plunged the family into financial distress. “Now we are all able to eat enough,” the father said. “And the other children can get an education.”
Mbolonzi Mbaluka understands. A Kenyan living with type 1 diabetes, he has had to skip insulin injections, sometimes because he could not afford the cost and sometimes because local hospitals ran out of stock. A fellow Kenyan patient recently died after going two months without insulin, which in many countries can cost up to 50 percent or more of the average income. For example, in Brazil, insulin and supplies can cost over 80 percent of an average income. “The insulin and the equipment together are just not affordable for many,” Mbaluka says.
Insulin is a pancreas-created hormone that allows the body to absorb and deploy sugar from consumed food. For people with type 2 diabetes, the pancreas struggles to keep up with the body’s insulin demand, either because the Over 400 million people globally have diabetes. Lack of widespread testing makes it hard to apportion the percentages between type 1 and type 2, but the majority of those people have type 2 diabetes. And according to some estimates, half of those who need insulin cannot reliably get access to it. People with type 2 diabetes often need to take insulin shots on a temporary or permanent basis. For people with type 1 diabetes, the equation is much more uniform, and more stark: they must inject insulin in order to stay alive.
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