Type 1 diabetes (T1D) is a lifelong condition that requires constant attention — insulin, food, timing, and vigilance. For the nearly 10 million people worldwide living with T1D, managing their health extends far beyond clinic visits or prescriptions. It takes place at kitchen tables, in school corridors, and in the decisions families make every day.
Handling those daily decisions can be overwhelming, especially in many low- and middle-income countries (LMICs), where that burden is intensified by limited access to care and medicine. While clinics provide essential care and guidance, families are often left to navigate the practical realities of management on their own. Bridging the gap between clinical guidance and daily life requires knowledge, supplies, and support that reflect a person’s everyday reality — especially where inconsistent insulin access, high out-of-pocket costs, and limited specialist care make daily management fragile.
Closing that gap starts with strengthening the systems that support families every day. Powered by Panorama Global, with seed funding from Helmsley, the T1D Community Fund invests in community-based organizations working on the frontlines of care. In many LMICs, gaps in health systems mean that managing T1D often depends on what support exists beyond the clinic — at home, in schools, and in their community.
In Addis Ababa, Ethiopia, Health Poverty Action (HPA) brings this approach to life through its Integrated Intervention for Children Affected by Type 1 Diabetes initiative. The program pairs diabetes self-care education with livelihood support for families, recognizing that managing T1D depends on both knowledge and economic stability. HPA’s team includes people living with diabetes, ensuring the program is informed by lived experience alongside clinical and community expertise.
HPA’s work extends beyond individual families through peer support groups, where people living with T1D and their caregivers share knowledge, navigate challenges together, and reduce the isolation that chronic illness so often brings.
Here’s what this community-centered approach looks like in practice.
For families raising children with T1D, care is woven into the realities of everyday life. Recognizing this, the HPA team works directly with households in Addis Ababa to understand how diabetes management fits into daily routines — from meals to school schedules to household finances.
Through home visits, HPA staff spend time with caregivers discussing practical questions: how insulin timing aligns with available food, what challenges arise during the school day, and where gaps in understanding or resources may exist. These conversations allow the team to share tailored guidance on diabetes self-care and connect families with nearby health providers for follow-up support.
HPA also supports families in navigating the school environment. When teachers or school staff are unfamiliar with the day-to-day needs of children living with T1D, the team encourages conversations and helps bring parents and staff together to talk about the best ways to support a student with T1D. These sessions focus on recognizing signs of high and low blood sugar and responding appropriately during the school day, helping create safer, more supportive learning environments.
For many households, the cost of insulin and devices can be an issue. Because consistent diabetes management depends on both insulin and nutritious food, economic stability is not separate from health — it is foundational to it. As part of its integrated approach, HPA works with caregivers to identify opportunities to work and earn money that build on existing skills. This may include small-scale, home-based jobs, alongside basic training and starter support, to help families better manage ongoing costs associated with diabetes care.
This kind of day-to-day support is already making a difference. As Mirchaye Mekoro, Director of Health Poverty Action Ethiopia, shared: “We’re proud to be part of the T1D Community Fund and are already seeing the early impacts. Through patient advocacy and school engagement, we’re breaking taboos and reducing discrimination. For instance, a child living with type 1 diabetes, who once hid his condition out of fear and assuming that there are no other cases like him, found confidence after connecting with peers through our program after realizing he was not alone. Today, he has become an advocate, educating other children about the condition and its care. This reflects the broader change we are having, including empowering children and their families through awareness, advocacy, and livelihood support.”
Taken together, these efforts reflect how HPA supports families through a set of connected interventions that address the realities shaping daily life with T1D.
What happens inside a single household is shaped by the systems around it. Working alongside families across Addis Ababa, HPA helps identify shared needs and gaps across the community. HPA’s integrated model recognizes that health outcomes are shaped not only by clinical expertise, but by household stability, school awareness, and community knowledge.
In practice, HPA’s approach includes:
When families have the resources to purchase both insulin and nutritious foods, children experience fewer dangerous swings in blood sugar. When teachers recognize the signs of low blood sugar, they can act early and confidently. And when frontline health workers are equipped with up-to-date training on T1D, care becomes more responsive and better coordinated across homes, schools, and clinics.
Children living with T1D deserve the support to be happy and healthy — not just in clinics, but in morning routines, in classrooms with friends, and in safe and stable homes.
By supporting the critical work of community-based organizations like HPA, the T1D Community Fund strengthens person-centered approaches that connect medical care with the practical conditions that shape it. It helps ensure that clinical guidance translates into everyday management for people living with T1D and their caregivers.
T1D care may begin in the clinic, but it succeeds in the community.
