Children and youth with diabetes in the developing world often face a perilous future. Insulin and test strips may be unavailable or unaffordable, and medical expertise limited. Children can die undiagnosed or perish from ketoacidosis or hypoglycaemia. Chances of completing education, gaining employment and marriage prospects are reduced, and early, serious complications frequently develop in young adulthood. Worldwide, an estimated 70-100,000 children and youth are in need of assistance.

The International Diabetes Federation’s Life for a Child (LFAC) Program commenced in 2001 and is managed from Sydney with the help of Australian Diabetes Council. Its purpose is to support the provision of best possible health care, given local circumstances, through the strengthening of existing youth diabetes services. Assistance may include insulin, syringes, meters, strips, HbA1c testing, education materials, health professional training, and education support. Currently, LFAC assists over 11,000 children and youth (up to 26 years) in 43 countries.

Program highlights include markedly reduced death rates, introduction of self-monitoring and HbA1c testing, improved clinic protocols, and establishment of diabetes camps. Other initiatives include: the Global Index of Diabetes Care for Children and Youth, a measure to document and compare critical factors influencing outcomes; launching of a custom-designed online clinical database; facilitating twinning/mentoring relationships between developed and developing country centres; research studies; Diabetic Ketoacidosis Awareness Campaign aiming to reduce deaths from misdiagnosis and late diagnosis; a website offering a wide variety of free education resources in eight languages; development of pocketbook guidelines for health professionals in less-resourced countries; and piloting of vocational training, education scholarships, and microcredit programs.

There are major global challenges regarding accessible insulin, supplies and medical care for children and youth with diabetes. However, in a number of countries the situation is transforming, through the combined efforts of local diabetes centres, LFAC, and other programs.