During our annual dental trip to Nicaragua in June 2015, the Asociacion de Padres de Nino y Jovenes Diabeticos de Nicaragua (APNJDN) introduced us to Rosa L. who is 23 years old.  Rosa was diagnosed with Type 1 diabetes at age eleven. Her mother has Type 2 diabetes and was diagnosed at the same time as her daughter. 
Although her paternal grandmother died of diabetes, Rosa is the only one of her two sibling with diabetes. During our visit, Rosa was suffering with a severe infection - sores and ulcers all over her body.  She cannot be hospitalized at the specialized children’s hospital, “La Mascota,” because she is a young adult and they only hospitalize children under 15 years of age. 
Rosa medicates herself on a fixed dosage. She infrequently monitors her levels because she has no means to buy on her own test strips.  She tests based upon how she feels and on how many test strips APNJDN can give her.  Rosa’s mother cannot work and her father works in construction whenever he can find employment. Asked about her quality of life, she said she has mobility problems and is unable to find a job. (under “Projects, see Diabetes Initiative”)
Author:  Gary Underwood

One month before our June 2015 interview with Erelis P. L., a 3-years old with Downs Syndrome child, Erelis was diagnosed with Type 1 diabetes. She lives in Madriz, a rural town in northern Nicaragua. Erelis’ mother has to walk 7 kilometers with Erelis to get to Madriz so they can a take a bus to the capital, Managua.  The only available health facility that can provide Erelis proper care and insulin is in Managua. The hospital staff in Managua gave Erelis two jars of insulin that should last until her September return appointment.  A close cousin of the mother also has diabetes. Erelis’ father is farm worker and the mother does not work.  It is undetermined if Erelis’ family will be able to adequately monitor her blood sugar and adjust her insulin levels. (under “Projects, see Diabetes Initiative”)