LAUSR

A century ago, type 1 diabetes mellitus (T1DM) was almost fatal. Since the discovery of insulin by Banting and Best in 1921, T1D became a chronic condition, but still requiring lifelong treatment. A century later, we have gained a deeper understanding of the disease and increased accessibility to anti-diabetic advancements such as insulin analogs, continuous subcutaneous insulin infusion, and continuous glucose monitoring devices.The quality of life of patients has been greatly improved, but many challenges remain (1). Whether or how these advanced technologies help improve glycemic control needs to be ensured, especially in lowand middle-income Countries. The incidence of T1D in children increased significantly in developing countries (2–5), so did the incidence rate of type 2 diabetes with the growing prevalence of obesity (6, 7). Lowand middle-income countries are facing bigger challenges in disease prevention and control (8). Nowadays, many studies aim to explore the clinical status of diabetes care and the related etiology. The objective of the Research Topic “Childhood Diabetes in Lowand Middle-Income Countries: Progress, Challenges and Actions Needed” was to gather original research articles illustrating the recent advances concerning the diabetes in Lowand Middle-Income Countries. This Research Topic consists of seven original articles. Two original articles investigated the features, treatment status and glycemic control of children with T1DM in China. Hou L. et al. investigated the features and treatment status of children with T1DM from 33 medical centers in China, and found that the patients were still predominantly receiving multiple daily subcutaneous injections of insulin. The proportion of patients using insulin pumps was only 15.21%, much lower than that reported for developed countries. The blood glucose monitoring was also insufficient. It has been reported continuous subcutaneous insulin infusion (CSII) was not superior to MDI on the glycemic control in long-term follow up.In lowand middleincome countries like China, medical insurance companies don’t pay the costs of the insulin pump, so insulin injection is a cost-effective therapy for Chinese children. Chen X L et al. reviewed publications on HbA1c concentrations in patients aged less than18 years which showed that the glycemic control of children with DM improved during the last decade in east China, but even in high-income countries, there were still 67.6% children with DM whose HbA1c levels are suboptimal. Although accessibility to anti-diabetic advancements such as insulin analogs, CSII, and continuous glucose monitoring devices, have increased, huge efforts are needed to optimize the glycemic control in childhood diabetes all over the world. It also pushes us to develop comprehensive methods in addition to the advanced glycemic control instrument in use.