How Better Care Models Are Helping Young People with Type 1 Diabetes in India

In West Bengal, India, researchers set out to test whether a new kind of clinic system could make Type 1 diabetes care more accessible and effective. The model placed specialized diabetes clinics inside existing district hospitals—government-funded facilities that many families could reach. Between 2022 and 2026, 366 young people with Type 1 diabetes enrolled in the program.

Most participants were teenagers or younger, with a median age of 15 years. Many came from lower-income families, and most had parents or caregivers without formal primary education. These were exactly the communities that often struggle most to access and afford diabetes care.

All participants moved to a basal-bolus insulin regimen—a standard approach that uses long-acting and fast-acting insulins to manage blood sugar throughout the day. The clinics scheduled structured monthly follow-up visits, meaning families knew when to return and what to expect.

The program tracked several key measures: blood sugar control (HbA1c), how young people and families felt about living with diabetes, and what they spent on diabetes care each month. Researchers checked in at the start, after 12 months, and again after 24 months.

When participants started the program, their median HbA1c—a measure of average blood sugar over three months—was 79 mmol/mol, or about 9.4% on the percentage scale. This indicated that blood sugar had been running higher than the targets doctors typically recommend.

After 12 months in the program, median HbA1c dropped to 72 mmol/mol (8.7%). By 24 months, it had fallen further to 64 mmol/mol (8.0%). These improvements happened consistently across the group, with no dropouts and participants averaging 23.5 clinic visits over the two years.

One of the most striking findings was what happened to family expenses. Median monthly costs fell from about 2,600 Indian rupees (roughly $30) at baseline to just 200 rupees (about $2) by month 24. This dramatic reduction likely reflects the government subsidy for insulin and clinic care, removing a major financial barrier to treatment.

Over the 24-month period, no participant experienced documented diabetic ketoacidosis—a serious, life-threatening complication. There were no emergency hospital admissions or deaths related to diabetes. Young people and their families also reported improvements in psychological well-being as diabetes management became more stable and affordable.

This study from West Bengal offers a real-world example of how diabetes care can improve when clinics are placed within existing hospital systems, insulin is subsidized, and families have consistent access to follow-up visits. The results suggest that the barriers to good Type 1 diabetes care in lower-middle-income countries may be partly structural—about access and cost—rather than about willingness or ability to manage the condition.

While this model is specific to West Bengal's healthcare system, the findings raise questions about how similar approaches could be adapted elsewhere. The consistency of results across a diverse group of young people and families suggests the model addresses real needs.

Source: Diabetic medicine : a journal of the British Diabetic Association. 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.