P-456: A scalable community charity digital support program from Kerala, s.India in children and adolescents with T1D
J Kesavadev, A Shankar, B Saboo, G Sanal, A Basanth, P Varghese, S JothydevAbstract
Introduction
Despite innovations, outcomes in type 1 diabetes (T1D) remain largely unchanged in India. Recognizing critical gaps, P. Kesavadev Trust facilitated the formation of an organization for parents/individuals with T1D in 2018 and subsequently established a 24/7 digital multidisciplinary team-led, family-supported care model.
Objectives
To describe the impact of this online and offline charitable model on T1D outcomes in children and adolescents across Kerala, India.
Methods
The implemented digital model was supported by physician-led multidisciplinary team providing continuous guidance. Large-scale digital support WhatsApp groups were established, comprising 3000 parents/T1D across the state, irrespective of treatment center. The model included 24/7 online support, structured education programs, periodic in-person camps, and quarterly psychological interventions free of cost. Observational comparisons were performed before and after engagement, focusing on glycemic control, acute complications, treatment adherence, and behavioral practices.
Results
Abandonment of insulin therapy in favor of traditional medicines almost disappeared. Episodes of diabetic ketoacidosis requiring hospitalization, previously frequent with occasional mortality, declined substantially, with deaths due to DKA reduced to almost zero. Severe hypoglycemia declined as families gained confidence in self-management. Mean HbA1c improved by approximately 1–1.5% following sustained engagement. Psychological support improved mental health among children and caregivers. Stigma-related practices, including keeping T1D a secret, were almost completely eliminated. Peer support strengthened family resilience. Continuous education increased demand for advanced diabetes technologies; however, access to CGM and AID remains limited, with government support largely restricted to human insulin and strips.
Conclusions
This scalable charity model integrating 24/7 peer support and family empowerment significantly improved T1D outcomes in Kerala.