P-485: Improving access to insulin, education, and psychosocial support in type 1 diabetes: a comprehensive program in children and young people in Panama
P Gomez Salazar, T Carles, D Moraes MorelliAbstract
Introduction
Type 1 diabetes (T1D) management remains challenging in settings with limited access to comprehensive care. In Panama, rising incidence among children and adolescents highlights gaps in equitable access to insulin, supplies, education, and psychosocial support, essential for optimal control.
Objectives
To analyze the effect of an innovative comprehensive program delivering insulin, essential supplies, diabetes education, and psychosocial support on T1D management in children, adolescents, and young people in Panama.
Methods
A sequential explanatory mixed-methods observational study was conducted. Participants included individuals aged 0–25 years with T1D, their families, healthcare professionals, and educators involved in the program. The intervention consisted of biannual provision of insulin and supplies, combined with education and psychosocial support. Quantitative analysis used descriptive and exploratory inferential statistics, while qualitative analysis was based on in-depth interviews. Ethics committee approval and registered (RESEGIS No. 4411).
Results
Between 2022 and 2024, 868 kits were delivered. A total of 259 participants were enrolled by visit 8. Median age was 14.1 years (SD 5.8), and 61.4% were female. Median time since diagnosis was 3.4 years (IQR 1.4–7.7), and 65.6% had uncontrolled HbA1c at baseline (median 8.2%). Process indicators showed high and sustained monitoring coverage across visits, with HbA1c assessed in 84-100% of participants. Participants reported that improved access to insulin reduced treatment barriers and increased self-management confidence. Education and psychosocial support enhanced daily care, while professionals identified the integrated approach as key to improving adherence.
Conclusions
This program shows that combining access to insulin, education, and continuous support improves adherence and is perceived to enhance quality of life in people with T1D and their environment.