What Gets in the Way of Blood Sugar Control for Young People with Type 1 Diabetes in Ghana

Diabetes in children and young adults presents serious challenges everywhere, but the burden falls particularly hard in low- and middle-income countries. In Ghana, researchers wanted to understand why—even though youth with Type 1 diabetes can access free insulin and self-management supplies through donor-supported programs—many still struggle to keep their blood sugar in a healthy range.

Poor glycemic control (high average blood sugar) raises the risk of both immediate complications and long-term damage to the eyes, kidneys, heart, and nerves. Identifying what stands in the way of better control is the first step toward solutions.

Between July and December 2025, researchers at a pediatric and adolescent endocrine clinic in Ghana gathered information from 161 young people under age 30. They used a mixed-methods approach—combining hard numbers with personal stories.

Participants completed structured interviews that asked both yes-or-no questions and open-ended questions about their experiences. Researchers measured blood sugar control using HbA1c, a test that shows average blood sugar over the past three months. They also reviewed medical records and explored topics including family support, institutional support from clinics, socioeconomic barriers, stigma, and whether young people felt comfortable disclosing their diabetes to others.

The majority of participants (88.8%) were adolescents or young adults, and 81% had Type 1 diabetes. Their average HbA1c was 9.97%—well above the target most clinicians aim for. This means blood sugar control was poor across the group.

The research revealed that barriers to good control are layered. They include socioeconomic challenges, the amount and quality of support from family and clinics, and the stigma many young people feel about having diabetes. These factors work together to shape whether a young person can manage their condition effectively.

This study underscores that access to free insulin and supplies, while essential, is not enough on its own. The real world of managing Type 1 diabetes includes navigating finances, relationships, school or work, peer acceptance, and health system resources.

By understanding these specific barriers in a low- and middle-income setting like Ghana, researchers and healthcare teams can design better support systems. The findings also offer insights for communities worldwide facing similar challenges in helping young people achieve and maintain good glycemic control.

Source: BMC endocrine disorders. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.