independent

Saturday 19 April 2014

Standard of diabetes care leaves a lot to be desired

People with type 1 diabetes have to take insulin injections, and must also ensure that their blood glucose levels are balanced.
People with type 1 diabetes have to take insulin injections, and must also ensure that their blood glucose levels are balanced.

THE economic recession has been bad for health services catering for young people with type 1 diabetes, according to a new study.

People with the condition who are not living in cities – and do not have access to large hospitals – are worst off.

There are around 30,000 people with type 1 diabetes in Ireland, and 2,500 of these are under the age of 19 years.

People with type 1 diabetes have to take insulin injections, and must also ensure that their blood glucose levels are balanced.

However, this new study, which looked at services for young people with the condition, has found that austerity is having a serious impact on the kind of care they can expect.

Most of those interviewed said the quality of care for young adults with diabetes in Ireland was poor, according to findings presented to the Royal College of Surgeons.

"Healthcare services for many young adults with diabetes were characterised by long waiting times, inadequate continuity of care, over-reliance on junior doctors, and suboptimal professional-patient interaction times.

"Many services lacked funding for diabetes education programmes, diabetes nurse specialists, insulin pumps, or for psychological support, though these services are extremely important components of high-quality type 1 diabetes healthcare."

"Services such as podiatry (for footcare) and dietician services appear to be under-funded in parts of the country.

"While Irish diabetes services lacked funding prior to the recession, the economic decline in Ireland, and the subsequent austerity imposed on the Irish health service as a result of that decline, appears to be impacting them even further."

The researchers were from the college's department of public health and epidemiology, the department of psychology, Connolly Hospital and Beaumont Hospital.

They found that a number of the young adults who took part in this study felt that they had to pay to gain access to basic diabetes services – such as speaking to consultants, or getting their feet examined.

"A number of healthcare services for young adults with diabetes appeared to be providing excellent quality of care; however, it appears that these services were mainly concentrated in larger, more urban areas, particularly in teaching hospitals."

Diabetes has to be controlled, as the condition leaves a person up to five times more likely to develop heart disease or have a stroke.

Poorly controlled blood glucose levels increase the chances of developing atherosclerosis, a furring and narrowing of the blood vessels.

They are also at higher risk of developing kidney damage, serious eye damage, or foot ulcers, which can result in infection.

The Health Service Executive (HSE) said it was now appointing 17 new integrated care diabetes nurse specialists who will link up with services provided in hospitals and the community to help more people manage their diabetes.

Dr Diarmuid Smith, who oversees the HSE's national diabetes programme, said this effort would greatly enhance the services to patients.

Type 1 diabetes usually runs in families. If someone has a parent, brother, or sister with type 1 diabetes, they have a 6pc chance of also developing the condition.

The risk for people who do not have a close relative with type 1 diabetes is just under 0.5pc.

Dr Nina Byrnes describes life with diabetes on p9

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