HEALTH CARE PROVISION FOR CHILDREN WITH DIABETES IN UKRAINE

Abstract

Diabetes mellitus is one of the most common human diseases that lead to disability and death. According to the reports of Ministry of Health, in Ukraine at the end of 2018 there were about 1,300,000 diabetic patients and 9,000 of them were children under 18 years of age. The sooner a child is diagnosed with diabetes, the more likely he/she is to save from the complications that cause disability and premature death. Solving issues on diabetes is one of the top priorities of national health systems. Purpose. The paper is aimed at the study of current health care provision for children with diabetes. Methods and Material. The steps in organization of health care provision for children with diabetes in Ukraine have been studied. The following methods have been used: bibliosemantic: for the analysis of scientific literature; content-analysis: to study the regulatory framework; system analysis: to analyze the organizational provision of health care for children with diabetes. Results. Type 1 diabetes is characterized by the destruction of beta cells, which leads to absolute insulin deficiency. About 75% of all type 1 diabetes cases are diagnosed in people under 18 years of age. Children and adolescents are assigned to a special category of patients who need more attention from physicians. Children find it difficult to understand what negative manifestations and the development of specific complications, leading to early disability, can be caused by a persistent and long-term decompensation of the disease. Based on the Adapted Clinical Guidelines for Type 1 Diabetes, the Working Group has developed Unified Clinical Protocols for Type 1 Diabetes in Young People and Adults and Type 1 Diabetes in Children, using evidence-based provisions for the effectiveness of medical interventions, which also served as the basis for identifying quality indicators for the health care provision for patients with type 1 diabetes. The main directions of the developed therapeutic and rehabilitation approach to medical assistance for patients with type 1 diabetes are the provision of medical, psychological and social assistance by multidisciplinary teams, involving an endocrinologist, specialists (therapist, neurologist, ophthalmologist, nephrologist, pediatrician), a social worker, a guidance counselor at the Diabetes School, a nurse. First of all, it is necessary to raise the awareness of physicians, especially at the primary level. The improvement of outpatient and in-patient care for children with diabetes, involving children themselves and their parents is also relevant. It is important to organize and provide an effective school for diabetes awareness and self-control. It is indisputably necessary to constantly and continuously monitor the state of clinical and metabolic compensation of diabetes. Attention should be paid to the need for more active use of the advanced technologies, such as pump insulin therapy. The main components of treatment are diet and insulin therapy, which the child must keep to throughout the whole life to compensate his/her health state. The role of the international diabetes movement in overcoming the diabetes epidemic in Ukraine and worldwide is noteworthy, since it called on all nations to adopt National Diabetes Prevention and Treatment Programs. Consequently, the Ministry of Health of Ukraine, together with international and national experts, has developed a number of fundamental legal acts that initiate structural changes in the health care system. Conclusion. Ukraine is one of the countries with the highest incidence of diabetes. Currently, there is a very significant increase in the incidence of diabetes among children of preschool and school age. Therefore, solving issues on diabetes is one of the top priorities of national health systems. Consequently, the life of a sick child depends on the level of organization of medical and social assistance. It is crucial that awareness and support for diabetes self-management, drug therapy and psychosocial assistance be provided from the time of diagnosis and regularly thereafter. Living a long life with diabetes is possible in proper disease control and prevention. In recent years, diabetes treatment has improved, though it has not solved all the problems. The novel modes of treatment are being actively implemented, namely, insulin analogues and insulin pumps.