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Adoctorguidesaparentandherchildonhowtoinjectinsulin.Photobenhviennhitrunguong.gov.vnHàN?I-Type1diabetescurrentlyaccountsfor90percentofdiabetescasesinchildren.InVi?tNam,datafrommajorpaediatrichospitalsindicatethatnearly2,000childrenhavebeendiagnosedwithType1diabetes,withtheconditionshowinganincreasingtrend.Diabetesisaglobalpublichealththreat,includinginVi?tNam,saidNguy?nTr?ngKhoa,DeputyDirectoroftheDepartmentofMedicalExaminationandTreatmentManagement.Diabetescausesnumeroushealthcomplicationssuchascardiovasculardisease,eyeproblemsandnervedamageandisamajorcauseofkidneyfailureandothercomplications.Diabeticpatientswithcomplicationsnotonlyfaceincreasedmedicalcosts,butalsoareducedqualityoflife.Medicalexpensesforadultdiabetespatientsaccountfor12percentofglobalhealthcarecosts.AccordingtotheInternationalDiabetesFederation(IDF),around537millionadultsworldwidewerelivingwithdiabetesin2021,anumberprojectedtoriseto783millionby2045.AccordingtoKhoa,uptohalfofalldiabetescasesremainundiagnosed.ManypeoplelivewithType2diabetesforanextendedperiodwithoutrealisingitandbythetimetheyreceiveadiagnosis,complicationshaveoftenalreadysetin.However,70percentofType2diabetescasescanbepreventedordelayedthroughhealthylifestylechoices.ComprehensiveepidemiologicaldataonType1diabetesinchildrenisnotyetavailableinVi?tNam.However,datafromleadingpaediatrichospitalsindicateanincreasingtrendoverthepastsevenyears,highlightingongoingchallengesindiagnosisandtreatment.Tr?nMinh?i?n,PresidentoftheVi?tNamPaediatricsAssociationandDirectoroftheNationalChildrensHospital,explainedthatType1diabetes,alsoknownasinsulin-dependentdiabetes,canoccuratanyage,frominfancyonwards.Unfortunately,somecaseswereonlydetectedwhenthepatientwasinacriticalcondition,suchasacomaordiabeticketoacidosis.ThecausesofType1diabetesarelinkedtovariousfactorssuchasgeneticsusceptibility,environmentalinfluences,theimmunesystemandβ-cellfunction.However,thespecificrolesofthesefactorsarestillunclear.PatientswithType1diabetesrequireinitialinsulintreatmentinthehospital,followedbystabledosemanagementathome.Thefocusshouldbeonmonitoringandappropriatetreatmenttominimisecomplications,?i?nsaid.Previously,theNationalChildrensHospitalmanagedonly10-15casesofType1diabetesannually.However,inrecentyears,thenumberofcaseshasrapidlyincreased,withhundredsofchildrennowreceivingtreatmenteachyear.Thehospitalcurrentlymanagesabout200-300childrenwithType1diabeteswhoregularlyattendforcheck-upsandtreatment.?i?nhighlightedthatifonlyafewmajorhospitals,suchastheNationalChildrensHospital,ChildrensHospital1,andHu?CentralHospital,managedthesepatients,itwouldbechallengingduetothelimitednumberofpaediatriciansspecialisingindiabetes.Hesuggestedexpandingthemanagementnetworktomorehealthcarefacilities,includingsmallerunitscapableofhandling15-20patients,toalleviatetheburdenonmajorhospitalsandreducetheneedforpatientstotraveltothebiggerhospitals.HealsoadvisedfamilieswithchildrenundergoingtreatmentforType1diabetestoworkcloselywithhealthcareprofessionalstomanagetheconditioneffectively,ensuringthatthechildrencanlivenormallives.Earlydetection,diagnosisandtimelytreatmentNguy?nTr?ngKhoafurtherexplainedthattostandardisetheexamination,monitoringandtreatmentofType1diabetesinchildren,theMinistryofHealthhadissuedspecificguidelines.Developedandbasedonbothdomesticandinternationalresources,theseguidelinesfocusontheclinicalpracticeofdiagnosingandtreatingType1diabetes.Theyareparticularlyusefulforgeneralpractitionersandspecialistsworkingintheirdailymedicalpractice,accordingtoKhoa.Theguidelinesaretheresultofcollaborationbetweentwoprofessionalassociations:theVi?tNamAssociationofEndocrinologyandDiabetesandtheVi?tNamPaediatricsAssociation.Thispartnershipbringstogetherexpertsinendocrinologyandpaediatricswithextensiveclinicalandteachingexperience.TheDepartmentofMedicalExaminationandTreatmentManagementonMondayorganisedanonlinetrainingsessionforgrassrootshealthcarestaffonimplementingtheguidelinesfordiagnosingandtreatingType1diabetesinchildrenandadolescents.Throughthistraining,theguidelinesfordiagnosisandtreatmentwillbeimplementedacrossalllevelsofmedicalexaminationandtreatmentfacilities,supportingbothgeneralandspecialisedpractitioners,Khoasaid.Theultimategoalisearlydetection,timelydiagnosis,effectivetreatment,andgoodcontrolofType1diabetes.Thiswillreducetheburdenonchildrenandfamilieslivingwiththeconditionandhelppatientsleadlongandhealthylives.VNSBùiV?nD?ng,33,andNguy?nTh?Ng?cwiththeirfirstbabythroughinvitrofertilisation(IVF)combinedwithembryoscreening.PhotocourtesyoftheAndrologyandInfertilityHospitalofHàN?iHàN?I—BùiV?nD?ng,33,andNguy?nTh?Ng?c,24,ayoungcouplefromtheimpoverishedcountrysideofL?cTh?yDistrictinHòaBìnhProvince,neverthoughttheywouldbecomeparents.Theymarriedin2018andlongedforachild.Duringtheirfiveyearsofmarriage,Ng?cconceivednaturallythreetimesbutsufferedmiscarriageseachtime.Feelingsad,exhaustedanddisappointed,Ng?candherhusbandsavedupandwenttotheAndrologyandInfertilityHospitalofHàN?iin2022forahealthcheck.Itwastherethattheylearnedbothcarriedthegeneforthalassemia,ahereditaryblooddisorder,whichwasthecauseofNg?csrepeatedmiscarriages.Aglimmerofhopeappearedwhenthedoctoradvisedthattheyhada25percentchanceofhavingahealthybabythroughinvitrofertilisation(IVF)combinedwithembryoscreening.However,thehighcostmadethemconsidergivingup.Theyweretheninformedaboutaprogrammebythehospital,offeringfreeIVFtreatmentto15infertilecouplesindifficultcircumstancesfromvariouscitiesandprovincesacrossthecountry.Thecoupleregisteredandreturnedhometowait.Lucksmiledontheminearly2023whenthehospitalcalledtoinformthemthattheywereeligibleforthefreeIVFsupportpackageanditsmiledagainwhentheysuccessfullyconceivedonthefirstattempt.InAugust2023,thecouplewelcomedtheirnewbornbaby.Reflectingontheirsix-yearjourneytoparenthood,D?ngsaid:Ourchildisalmostoneyearold,butIcantforgetthehappinessIfelthearingthefirstcryatbirth.Tootherinfertilecouples,keephopingandtrustinmodernmedicine.Ifthebabydoesntcometoyou,seekitout.FifteeninfertilecouplesindifficultcircumstancesreceivedfreeIVFtreatmentattheAndrologyandInfertilityHospitalofHàN?i.PhotocourtesyoftheAndrologyandInfertilityHospitalofHàN?iPhan?ìnhTh?ng,34,andBN??chTh?Tron,36,couldnthidetheiremotionsastheyrecountedtheir12-yearjourneytoparenthood.Tron,fromtheC?TuethnicgroupinQu?ngNamProvince,andTh?ng,fromtheKinhethnicgroupinHàT?nhProvince,overcameculturaldifferencesandgotmarriedin2012aftersometimeofgettingtoknoweachother.Justayearlater,Tronbecamepregnantnaturallyandtheyoungcouplesjoyknewnobounds.However,thisjoywasshort-livedwhenTronsufferedamiscarriageateightweeks.ThefamilysincomereliedsolelyonthreeacresofricefieldsandtheoccasionalworkTh?ngdidharvestingacaciatreesforadailywageofVN?150,000.In2014,aftersavingsomemoney,thecouplewenttoHàN?iforamedicalcheck-up.Thedoctorssaidtherewasnothingwrong.Feelingreassured,wewentbackhometocontinuehopingforgoodnews.Butastimewentby,thelongerwewaited,thelesslikelyitseemedwedeverhavethehappinessofwelcomingachildandthislastedfor12years,saidTh?ng.Duringthattime,wehardlydaredvisitanyoneforfearofhearinghurtfulremarksaboutourinabilitytohavechildren.Someevensaidourfamilywascursed,Tronrecounted.Attheendof2023,theyheardfromaneighbourwhohadachildthroughIVF.ThecoupleonceagainwenttoHàN?iforacheck-upandtheywereguidedthroughtheprocessofapplyingforfreeIVFtreatment.Th?ngsaidthathecouldntbelievetheirluckandtheyeventhoughtitmightbeascamuntiltheyreceivedtheofficialsupportdecisionandsawotherinfertilecoupleswhohadsucceeded.Thisrenewedtheirhopeofhavingachild.Nguy?nV?nChamfromtheTàyethnicgroupinHàGiangProvinceandhiswifesharedasimilarsentimenttoTh?ngwhentheyreceivedacallnotifyingthemthattheirapplicationhadbeenapproved.Isawanunfamiliarnumberanddidntanswerbecausetherearesomanyscamcallsthesedays.ThenmywifereceivedacallfromthehospitalinformingusthatweweregrantedfreeIVFtreatment.Webothcriedbutstillcouldntbelieveit,fearingitmightbeamistake,Chamsaid.Chamsfamilyarequiteunique.Hisfatherpassedawayearly,hismotherhascancer,hisgrandmotherisoldandfrailandhisbrotherhasalsobeeninfertilefornineyearsduetoageneticblooddisorder.Additionally,thefamilysupportstwoorphanedcousins.Allfourgenerationsliveinasimplethatchedhouse.Tosupportthefamilyandhelphisbrotherwithreproductivetreatment,ChamandhiswifemovedtoB?cNinhProvincetoworkasfactoryworkers.Ijusthopethatthistime,luckwillsmileonusandgrantusachild,Chamsaid.Forthesixthconsecutiveyear,thehospitalhasbeenprovidingfreeIVFtreatmenttocouplesinparticularlydifficultcircumstances,aimingtoalleviatetheirfinancialburdenandopenthedoortocompletehappiness.DrLêTh?ThuHi?n,thehospitalsmedicaldirector,said:Todate,morethan50familieshavereceivedfreeIVFsupport,resultinginthebirthof60healthybabies.Thisbringsusjoyandmotivationtocontinuetheprogrammeandofferadditionalsupportinthecomingyears.Inadditiontothe15couplesreceivingfreeIVFtreatmentthisyear,thehospitalalsoprovidesnumerousfreesupportpackagesforcasesrequiringadvancedreproductivetechniquessuchasMicroTESEforspermretrieval,hysteroscopyforuterineexploration,embryoscreeningforgeneticdiseasesandembryomonitoringusinganautomatedsystem.—VNS

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