IRISH PATIENTS with diabetes receive a better quality of care and enjoy a higher quality of life when they are looked after by doctors and other health professionals in the community rather than in hospital, a major research project has found.
The study of more than 2,000 patients with both type I and type II diabetes will be welcomed by the Health Service Executive (HSE) whose stated policy is to move the care of chronic disease from hospitals into the community.
At present, most people with diabetes are either looked after in hospital or under a shared care programme involving GPs and hospital doctors.
However, in the HSE Midlands region, where there is no local hospital-based specialist diabetes unit, using a structured form of primary care involving family doctors, community dieticians, chiropodists and specialist diabetes nurses, people with diabetes are looked after differently.
In a paper published in the American Diabetes Association journal, Prof Ivan Perry of the Department of Epidemiology and Public Health at University College Cork, Dr Velma Harkin, a GP in Banagher, Co Offaly and their colleagues found that patients’ blood sugars, blood pressure and other parameters were better controlled when cared for under the new plan.
When the researchers looked at the quality of life of participants – for example the effect diabetes had on their freedom to eat and drink and their anxiety about the disease – they found that patients looked after exclusively in the community had higher quality of life scores than those looked after using the traditional mixed care method.
"The findings provide clear evidence that the quality of care for selected diabetes patients treated in general practice is as good, if not better than, traditional treatment programmes," Prof Perry told The Irish Times.
Meanwhile the final phase of a Health Research Board funded study of diabetes among pregnant Irish women has got underway. The study of 10,000 women, led by Prof Fidelma Dunne, head of the school of medicine at the National University of Ireland, Galway, found that half of pregnant women were either overweight or obese.
The researchers showed obesity was a risk factor for women needing a Caesarean section as well as for elevated blood pressure and having a baby who is overweight. “Babies from mothers with diabetes are at increased risk of weighing greater than 4kg at birth. This in itself increases the risk of obesity and diabetes in their adult lives,” Prof Dunne said.
The next stage of the study will attempt to identify the risk factors for persistent diabetes among women with a pregnancy induced version of the disease. Researchers also plan to develop an intervention programme for pre-pregnancy care for women with diabetes to see if stillbirth and congenital malformation rates can be reduced.