ONLY one of the 19 hospital centres treating children with type-1 diabetes had the recommended ratio of nurses to patients, according to a new study.
Insulin pump instruction was available in eight centres and the number of children using these alternatives to an insulin injection ranged widely from zero to 42pc.
The study, by the Department of Paediatric Endocrinology in Temple Street Hospital in Dublin, pointed out that type-c diabetes is a chronic condition affecting five to 40 per 100,000 of the child population.
The incidence is higher in the UK, Ireland and Scandinavia than in most of central and southern Europe and is rising, particularly in children under five.
The report in the 'Irish Medical Journal' showed a wide variation in the structure and process of care between centres. The authors said that "regionalising diabetes care for children with type-1 diabetes should be considered".
Large patient numbers are necessary to justify full-time employment of a large multidisciplinary team. "This would allow for the maintenance of skills, attendance at best practice meetings and improvement in patient care," said the study.
"It would also facilitate skilled out-of-hours coverage as well as emergency cover of sick leave. While this may improve patient outcomes, it will be associated with an increased requirement for patients to travel to appointments and careful geographic consideration of location of centres is required to mitigate the burden for families," it added.