DKA

DKA Calculator

Patient care tool
Improving the management of diabetic ketoacidosis in children in low-resource settings
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The project

In brief

Type 1 diabetes is a complex chronic disease that is particularly difficult to manage in low‑ and middle‑income countries. MSF is seeing a steady increase in diabetes‑related consultations across its projects, while access to insulin, blood glucose monitoring tools, and trained healthcare providers remains very limited.

Among the most serious complications is diabetic ketoacidosis (DKA), a medical emergency that can be fatal without rapid and accurate management. In some MSF intervention areas, such as Aweil in South Sudan, dozens of children are hospitalised each month due to this complication.

The MSF Foundation is leading an innovative project to adapt a clinical calculation tool already used in high‑income countries to support healthcare workers in managing diabetic ketoacidosis in resource‑limited settings. Co‑developed with medical experts and field teams, this tool aims to save lives by guiding clinical decision‑making.

Status of the project

  • Problem analysis
  • Development
  • Evaluation
  • Deployment
  • Capitalization and feedback

Identification of the need

In low‑ and middle‑income countries, type 1 diabetes remains a high‑risk condition. A 10‑year‑old child with type 1 diabetes has an average life expectancy of 13 years, compared with 65 years in high‑income countries.

The high cost of insulin and blood glucose monitoring devices limits access to care. Patients are sometimes forced to travel long distances several times a day to receive their treatment, putting their safety at risk.

Public healthcare systems do not always cover these essential treatments, and clinicians often lack training in managing such a complex condition. In this context, the management of acute complications—particularly diabetic ketoacidosis—is especially challenging, due to the shortage of specialists and limited access to laboratory testing.

The MSF Foundation’s response

The MSF Foundation is developing a clinical calculation tool designed to support healthcare workers in treating diabetic ketoacidosis in children.

Co‑developed with paediatricians, nurses, endocrinologists, software developers, and regulators, this tool analyses patient medical data alongside the resources available in order to recommend appropriate treatment adjustments. Its goal is to guide clinical decision‑making where specialists are unavailable, thereby reducing mortality associated with this life‑threatening complication.

 
 

News

In detail

Diabetic ketoacidosis

Diabetic ketoacidosis is an acute and potentially life‑threatening complication of type 1 diabetes. It occurs when the body lacks insulin and begins to burn fat as a source of energy, leading to the accumulation of ketone bodies and dangerous acidification of the blood.

In children, this complication requires rapid, accurate, and intensive management. However, in many MSF intervention settings, the lack of healthcare professionals specialised in paediatric endocrinology and the absence of laboratory testing make diagnosis and treatment particularly challenging, increasing the risk of death.

To find out more, watch the film tracing 10 years of diabetes care provided by MSF:

Diabetes (r)evolution(s)
diabete

L'équipe

  • Matt Cleary
    Matt Cleary
    Project advisor La Fondation MSF
  • Dan leach
    Dan Leach
    Paediatrician with interests in diabetes, endocrinology and health technologies Somerset NHS Foundation Trust
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