The Global Collaborative for Changing Diabetes in Children: inclusive research design and implementation

Type 1 diabetes (T1D) is a growing challenge for health systems globally, with much of the burden falling on children and adolescents in low- and middle-income countries. Despite being a preventable cause of early morbidity and mortality, large proportions of youth remain undiagnosed or receive suboptimal care, primarily due to weaknesses in health systems. The Global Collaborative for Changing Diabetes in Children was established in 2021 to respond to these challenges. The Collaborative includes five interrelated streams: research, data systems, education, translation, and innovation. At its core, intersecting all five streams, is the world’s largest cohort study of children and adolescents with T1D, designed with a harmonised research protocol resulting from a multi-country research prioritisation process. The Collaborative has fostered local ownership and participation through engagement with in-country clinicians and researchers in all stages of development. Data systems innovations, such as a user-friendly, artificial intelligence-powered EHR system and T1D registry, have enabled scalable, low-resource cohort infrastructure. Concurrently, capacity-building and training initiatives, including an online executive education course and in-person immersive workshops, have been developed and implemented to ensure full and sustainable research engagement. The Collaborative’s approach provides a model for interdisciplinary international research partnerships and aims to address data deserts, promote health equity and accelerate progress in chronic disease management for vulnerable populations. This manuscript describes The Collaborative’s design and early implementation outputs; analyses of clinical and health-service outcomes will be reported in future publications as cohort data mature.