Type 1 Diabetes

Equitable Care for People Living with Type 1 Diabetes: The PEN-Plus Model

Unlike their counterparts in high-income countries, children with type 1 diabetes in rural areas of sub-Saharan Africa often die within a year of diagnosis. This tragedy is as medically unnecessary as it is morally unconscionable.

To address inequities in care, the NCDI Poverty Network is working with 22 resource-poor countries around the world to implement PEN-Plus, an innovative, integrated-care delivery model for severe, chronic noncommunicable diseases such as type 1 diabetes, sickle cell disease, and childhood heart diseases. PEN-Plus clinics save the lives of those with type 1 diabetes, for example, by providing insulin and specialized care close to home, as well as money for food and transportation to the clinic.

“That night, my blood pressure got so high I started talking nonsense and passed out. My parents were terrified and took me to the health center. I was in a coma for five days before regaining consciousness. Symaque [A PEN-Plus nurse] taught me how to inject myself, so I could take my insulin to school with me.”

-Angelique Mukarakisa, a young woman living with type 1 diabetes in rural Rwanda

Meet people living with type 1 diabetes in PEN-Plus countries

Type 1 Diabetes Updates

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Undaunted Spirit Despite Dual Diagnoses
Undaunted Spirit Despite Dual Diagnoses

“Tawonashe is exactly the kind of patient for whom PEN-Plus was designed,” said Dr. Alvern Mutengerere, project manager for noncommunicable diseases at SolidarMed, the implementing partner for the PEN-Plus clinic in Masvingo.

Type 1 Diabetes Champion: Paladie’s Story
Type 1 Diabetes Champion: Paladie’s Story

“Much of my outreach work is focused on diabetes education because it’s important to eradicate the many misunderstandings about the condition. When I get in front of people, the first thing I say is that I’m living with type 1 diabetes. My energy and enthusiasm silence the voices that said I would die. People who live with type 1 diabetes and other severe noncommunicable diseases are no different from anyone else.“

Network Promote PEN-Plus at ISPAD Conference
Network Promote PEN-Plus at ISPAD Conference

A team that included NCDI Poverty Network Steering Committee Co-Chair Gene Bukhman as well as Type 1 Diabetes and Global Health Equity Research Fellows Celina Trujillo and Apoorva Gomber traveled to Abu Dhabi to represent the Network and promote PEN-Plus at the 48th annual International Society of Pediatric and Adolescent Diabetes (ISPAD) Conference, 13-16 October.