Surviving with Diabetes on the Yucatan Peninsula
Editor’s Notes: Beyond Type 1 recently sat down with María Cab, part of the team behind the Mexican Diabetes Association in Southeastern Mexico on the Yucatán Peninsula to discuss her work, the effects of the Covid-19 Pandemic, and the Life for a Child program. This interview has been translated from Spanish, and edited for length and clarity.
Until 2022, there have been wide gaps in the data about the incidence and impact of type 1 diabetes across the world. According to estimates from the type 1 diabetes (T1D) Index by JDRF, almost 90,000 people live with type 1 diabetes in Mexico, but almost 60,000 additional people would still be alive today if everyone had access to a timely diagnosis, vital diabetes supplies and management education. An average young person diagnosed at age 10 will lose an estimated 35 years of healthy life. Globally, there are an estimated total of 3.86 million people that would be alive today if everyone had equitable access to diabetes healthcare and tools. Learn more at T1DIndex.org.
BT1: What is the mission of the Mexican Diabetes Association in the Southeast?
María: Well, like many associations dedicated to diabetes, our mission is to prevent diabetes and promote diabetes management. We are doing this through educational programs, counseling and also through managing supplies to promote good self-management for people living with diabetes. Part of what characterizes the health professionals that we collaborate with is that they are empathic with the people who live and coexist with diabetes.
How many people does this association help and what are the services provided?
We have around 76 families that have a person who lives with type 1 diabetes and 120 to 200 people who live with type 2 diabetes. In the case of type 2 diabetes, every year we have new patients joining us so the number varies more, but many of them continue with us. After the initial service, they periodically come for check-ups and everything. As for services, one of them is the allowance we have for supplies, another one is nutritional, medical, psychological counseling and they also receive group education or workshops.
Every 15 days for our type 1 diabetes patients, a session is scheduled on a specific topic. We invite some health professionals or an expert in the subject, and they are the ones who share this information with us so that we can update ourselves and also educate the new members.
What impact has the pandemic had on the association’s work?
We were very used to seeing each other every 15 days so it was very difficult to transition to Zoom or other online platforms because not everyone knew how to use these platforms and not everyone had access to the internet. It was a bit difficult for us to carry out the workshops and we did not have the same attendance that we had when the meetings were live or in-person.
Delivering supplies for those who had allowances was also quite complicated. Many parents lost their jobs, so we found ourselves needing to support them with supplies even more. It affected us a lot, it took us a little while to adapt, but we are doing much better now. We are more used to using technology now and are able to dedicate the time, even online, to be able to educate ourselves and to continue providing this service.
How has the COVID-19 pandemic affected diabetes treatment in Yucatán?
Lack of access increased because many health services were suspended. Appointments that were scheduled could not be made, leading to no prescription renewals. And even when you finally got the renewal, there may not be insulin available.
Insulin is one of the most expensive supplies, and many did not have access to it. We already had an insulin bank where parents themselves exchange their insulins or come to donate them so that someone else can use them later, but the bank was empty. Suddenly we no longer had any insulin in stock because it was all being used, and we still had parents waiting to be able to get insulins.
Even before the pandemic, we did not have the specialists that are needed to care for people living with diabetes. Specifically, for example, there were no pediatric endocrinologists for the public health services. This was quite complex because people were cared for by an internist or by an endocrinologist, but not a pediatric one and they had to go and find this service from this type of doctor in private practice.
It has been a mess, but the truth is that we have received a lot of support from these professionals, and part of what the association does is to establish these contacts so that we can have much easier access to these services.
What is the Life for a Child program and how do you partner with them in Yucatán?
The Life for a Child program provides access to supplies for self-management. This program seeks to improve the well-being of people living with type 1 diabetes by promoting good self-management. We, as an association, benefit from this program and we are committed to offering other services that complement self-management so that we can promote a good quality of life for people living with diabetes. Part of what they give us, for example, is glucose meters, strips, lancets, and we as an association manage the rest of the supplies to try to provide as much as possible. In addition to that, periodic reviews are carried out on the people who belong to this program and they are given nutritional, psychological and medical guidance and we send reports of how they are evolving when they enter this program.
What is the most significant success story you have seen at Life for a Child?
We have so many success stories. The truth is that this program has allowed us to meet many people and experience this learning and evolution with them. The most impactful stories for me are the youngest children. Right now, our youngest patient is 4 years old. For them to be 4 years old and have them explain to you how they are going to monitor themselves and what they need to be able to take their insulin or how they are going to count carbohydrates is quite rewarding.
They see their diabetes as something that is absolutely normal. They talk to other people about diabetes like they are experts, and they are very young. In this case, one of the youngest members of our organization comes to mind. He is 6 years old right now and he started with us a year and a half ago, still very young, he would say, “I do not want to inject myself, I do not want to do this, I do not want to eat,” and now you see him, and he is a different person, he is completely changed and he knows a lot and speaks like an adult. That is very rewarding as a diabetes educator, seeing everything you do bearing fruit and young people with diabetes sharing their knowledge with others.
To find out how you can support young people living with type 1 in under-resourced countries visit Life for a Child.
This content was made possible in part with support from Lilly, an active partner of Beyond Type 1 at the time of publication. Beyond Type 1 maintains full editorial control of all content published on our platforms.