A new study will examine why Pasifika youth with type 1 diabetes are having problems maintaining good control of their disease.
University of Otago academic Dr Isaiah Immanuel is conducting the one-year study with funding from Research for Children Aotearoa.
Immanuel witnessed how delays in care and treatment can harm people living with chronic disease while growing up in Fiji.
His research suggests many young Pasifika patients are struggling to control their diabetes.
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“In many cases it’s not so much a lack of resource, but a lack of engagement or ability to engage,” he said.
“It seems many families aren’t able to utilise the clinical support systems already in place to help manage their child’s disease, such as attending regular clinic visits or staying in touch with the clinical team."
Immanuel said there has been little progress over five years in patient use of insulin pumps, their regularity in receiving continuous glucose monitoring and the HBA1C glucose markers in the patient’s blood.
“Five years ago, Pasifika children and youth were four to five times less likely to be using their insulin pump for glucose control compared to European New Zealand patients,” he said.
"Analysis of the current data shows only around one in seven Pasifika patients are using an insulin pump, which is still low."
He said continuous glucose monitoring is another issue.
"Having access to a monitor can save the young person from the pain of having to prick their finger to extract blood five to six times daily,” he said.
"The fact is, most Pasifika families struggle to afford one of these monitors. The cheapest on the market is around $4000 with some up to $10,000. The database shows our young Pasifika patients are five times less likely to be using continuous glucose monitoring as a result."
Immanuel said a lack of disease control can be life-threatening.
"If children don’t get their insulin, they can present to hospital very sick and even die within a week. Long-term they can lose their sight, kidney function and suffer nerve damage,” he said.
Immanuel has conducted interviews with specialist paediatric diabetes nursing teams in Auckland and Wellington for the study.
He said these have helped expose the challenges Pasifika families face in accessing care and support.
Specialist diabetes nurses also reporting difficulties communicating with some Pasifika families due to language and cultural barriers.
“Type 1 diabetes requires a lot of management and often both parents work long, unsociable hours,” Immanuel said.
"Although some services are government-funded and already at the table, some Pasifika families are struggling to even get to the table.”
Immanuel hopes the study will help bridge gaps for Pasifika families in accessing care.
"While there may only be an estimated 115 Pasifika children and teens with type 1 diabetes in Aotearoa, their levels of hospitalisation due to a lack of diabetes control are higher than they should be in percentage terms,” he said.
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