<scp>Action4Diabetes</scp>: a non‐profit organisation bridging the type 1 diabetes gap in Southeast Asia

The legacy of Dr Arnold Bloom is recorded on the Diabetes UK Roll Honour which aims to acknowledge people who have played an exceptional role in history diabetes. It incredible honour and a privilege be awarded 2023 Award for opportunity deliver this lecture. Type 1 diabetes (T1D) chronic disease that affects millions around world. International Federation (IDF) reports global incidence T1D estimated 15 cases per 100,000 population year.1 There has been increase over past few decades, particularly children under age five. reasons are not well understood, but it thought due combination genetic environmental factors. In UK, 400,000 affected by life expectancy reduced with T1D.2 remains leading cause blindness working age, renal failure second most common lower limb amputation. While condition can managed proper treatment care, those living low-middle income countries (LMICs) often lack access necessary resources, resulting poor health outcomes many T1D.1 LMICs, diagnosed late limited care services diagnostic tools. This delay diagnosis result high mortality rates from diabetic ketoacidosis (DKA). Once diagnosed, managing LMICs challenge. cost insulin other medications prohibitively expensive, do blood glucose monitoring devices, strips or essential supplies. As result, these must rely inadequate options putting their at risk lifelong complications such as nerve damage, blindness, kidney failure.3 growing concern Southeast Asia (SEA). SEA region includes Laos, Malaysia, Cambodia, Vietnam, Thailand, Singapore, Brunei, Indonesia Philippines, experiencing significant prevalence condition. One main challenges awareness education Many familiar signs symptoms T1D, there general understanding about how manage properly. universal coverage does include provision testing kits. Before 2016, no Laotian adult child was known survived.4 first publication SEA, average DKA were reported between 30–90% glycaemic index five reviewed 2020 2021 83mmol/mol (9.7%).5 factors insulin, unavailability kits contribute control complication adversely affect quality life. These exacerbated varying government policies, price transparency, complexity supply chains insufficient competition among industries make supplies.6 areas, facilities scarce, making difficult receive they need. Action4Diabetes (A4D; www.action4diabetes.org) UK-based non-profit organisation only charity currently providing comprehensive partnership programmes defined local hospitals through Memorandum Understandings (MOUs) signed governments guarantees ongoing supplies free hospital emergency funds young 0–25 years age. founded Charles Toomey Jerry Gore 2015 when his work industry made aware survival Myanmar Laos during visits there. person professional expedition mountaineer. Both close friends Royal Marines Officers earlier together formed A4D. A4D's mission non-government save empower deprived communities across them education. primary goals A4D educate management, provide raise partners organisations provides training resources providers improve communities. key (Figure 1). guarantee support old. Chiang Mai Bangkok Kanchanaburi Ubon Ratchathani Songkhia Surat Thani Mukdahan Phatthalung Khon Kaen 1. Maharaj Nakorn Hospital 2. Siriraj 3. Phahol Polpayuhasena 4. Sunpasitthiprasong 5. Hatyai 6. Suratthani 7. Mukadahan 8. 9. 10. King Chulalongkorn Memorial 20 11 42 3 5 10 8 Cambodia Siem Reap Phnom Penh 11. Cambodian Assoc Clinic 12. Preah Kossamak 13. Kantha Bopha 14. Jayavarman VII 15. National Pediatric 13 12 130 93 17 Yangon Mandalay 16. Children's 17. 550 67 Vientiane Luang Prabang 18. Mahosot 19. Friends Children 55 Malaysia Penang Sarawak Kedah Putrajaya Sabah 20. General 21. 22. Sultanah Bahiyah 23. 24. Likas Women 6 Vietnam Hanoi Ho Chi Minh City 25. 26. University Medical Centre 27. 2 52 organisation's achievements creation HelloType1 (Box 1; www.Hellotype1.com), innovative digital educational resource platform languages families professionals. All content reviewed, translated adapted towards culture panel international experts lay ensure information appropriate context. educate, engage professionals, families, carers creating free-to-access accurate up-to-date information, patient-oriented best practice each country. launched English Khmer March 2021, Vietnamese language 2022, Thai November 2022 Bahasa (Malay) 2023. 4000 professionals accessing regularly. – Family, caregivers People type Health Website Facebook page country Users’ engagement (including online workshops psychosocial support) Family Caregivers Support Group Patient family camps programme organised collaboration paediatric units successful improving management families. four old adults early 20s, members. A typical camp three-day event variety activities, carbohydrate counting training, monitoring, injection techniques, adjustments peer-to-peer support. participants trained help develop healthy habits achieve goals. also including eating sugar monitoring. To date, 18 Myanmar, engaging more than 1500 participants. ASPIRE scholarships part initiative further low-income households. poverty and, leads dropping out school losing ambitions gives aspirations. students enrolled supports gain higher vocational skill will lead gainful employment. actively involved SEA. critical preventing long-term complications. community members better understand its management. doctors allied educators nutritionists under-resourced hospitals, facilitates established tertiary-level institutions UK. Through mentorship programmes, helped 150 staff initiatives crucial building up sustainable capacity advocates improved medical support, closing gaps continue exist developed resource-limited countries. since conception supported Mynamar, Malaysia. 2023–2024, expand reach Philippines. 3.) Addressing requires multi-faceted approach. Despite challenges, now efforts underway bridge care. collaborations Society Adolescent (ISPAD) Life Child (LFAC)7 collaboratively condition, rural areas where limited. Internet boomed last decade affordable cheaper phones data access. Digital efficient solution out, foster both carers’ Additionally, upskilling continuous provisions. Government policy changes vital address issue affordability, greater transparency pricing, increased market, insurance seen globally places burden systems economic social impacts. Living challenging take toll mental constant adjustments, overwhelming anxiety, depression, issues.8 Research funding finding new treatments, developing cure, lives T1D. However, research limited, needed accelerate progress, especially LMICs. Investing specific faced effective solutions. lecture highlights need investment attention With right live fulfilling lives. Thank you team volunteers Action4Diabetes.org Special acknowledgement co-founders A4D, Gore. lived worked mid-1990s. His vast experience provided him deep ability design execute cost-effective sourcing delivery supplies, interventions Co-founder 2001 Blue Circle Champion 2015. He one UK's mountaineers, continues relentlessly fundraise series extreme mountain road bike year. thanks go Fiona Ooi, Regional Manager runs operations throughout data. Professor May Ng OBE voluntary Chief Advisor. She responsible advice, clinical, projects receives compensation, financial otherwise, personal contribution her work, either any sponsors. Chair Association Clinicians, NIHR Clinical Steering Young People, Officer College Paediatrics, European Paediatric Endocrinology (ESPE) E-learning advisory council.