Report shows improvement in diabetics' health with primary care, writes JOANNE HUNT
TACKLING smoking and obesity continue to be the major challenges in the provision of diabetes care, new research has found.
The findings were published yesterday in a report on the Midland Diabetes Structured Care Programme, a 12- year long initiative in which patients with the illness were treated by primary care services in their own communities.
Under the programme, which involved 3,700 patients and 35 general practices in the midlands, diabetes patients underwent a structured care plan provided by GPs and practice nurses.
Specialist support was provided by diabetes nurses, dietitians, ophthalmology and chiropody and podiatry services. Patients were referred to hospitals only when further specialist services were required.
Over 90 per cent of the group had type two diabetes and 56 per cent of the group was male.
The report found that the primary care programme delivered significant improvements in the management of blood glucose levels, cholesterol levels and an overall decrease in complications. Of all the diabetes sufferers treated, 50 per cent were obese and 20 per cent were smokers.
Dr David Weakliam, a consultant in public medicine with HSE Dublin and Mid Leinster, said: “The results are very encouraging. They show the high level of care that can be achieved in the primary care setting.”
However, Dr Weakliam said that tackling smoking and obesity would be critical to controlling overall rates of diabetes.
Describing the benefits of the programme which has operated in Laois, Offaly, Longford and Westmeath since 1998, Dr Weakliam said: “With GP visits three to four times a year, a patient’s medication can be adjusted to get the best results for them.
“This means that patients experienced fewer complications such as foot ulcers and this puts less pressure on our hospitals.”
Dr Velma Harkins, GP lead for the programme, said: “The advantages for the patient are convenience and accessibility, thus reducing time and travel costs.
“The GP and practice nurse also have an insight into all aspects of the patient’s condition and lifestyle.”
Up to 200,000 people in Ireland suffer from diabetes, a figure that’s set to increase by one-third by 2015. Obesity is cited as the single biggest driving factor of diabetes.
“The word ‘epidemic’ is not too strong for what we’re seeing with diabetes,” said Dr Weakliam.
“This programme is a model that can be used in other parts of the country,” he said, “but we must also tackle the challenges of smoking and obesity.”