Republic of Ireland behind in treatment of children with Type 1 diabetes, medic warns
The Republic of Ireland is “very far” from where it should be in the treatment of children with Type 1 diabetes, an expert in the disease has claimed.
A co-ordinated national strategy is vital to confronting the chronic condition, consultant Colin Hawkes said ahead of World Diabetes Day on Sunday.
A team at Cork University Hospital (CUH) treats almost 500 children with Type 1 diabetes, but insufficient resources mean it is not possible to see the youngsters every three months, as recommended, with some waiting six months or longer between appointments.
“We are also totally unequipped to address the psychological burden of this disease,” said Dr Hawkes, a paediatric endocrinologist at CUH.
“We are very far from where we should be, there is a lot more that we need to be doing to meet the needs of these children and their families.
“In CUH alone, we have an exceptional team but we should have six diabetes nurses for the number of children we care for and we only have three.
“We have submitted a business case requesting three more. It is extremely difficult to provide the care these children deserve at such low staffing levels.
“We also should be at the forefront of research in this condition and are working to generate energy and funding to build a research team and programme.
“This will help us to get studies off the ground and give the children of Ireland access to research that will change the future of this condition.”
In Type 1 diabetes patients, the immune system attacks the pancreas, destroying cells that make insulin, crucial for sending glucose to the body’s cells for energy.
When a child is diagnosed, they must learn to detect glucose levels and administer insulin throughout the day and night.
Advances in technology, however, have largely replaced the finger-stick glucose checks with glucose monitors and insulin injections with insulin pumps.
Possible signs of diabetes in children include increased thirst, frequent urination, bed wetting, reduced energy, unexplained weight loss, extreme hunger and vaginal thrush.
Dr Hawkes said: “We don’t fully know what causes Type 1. There is a genetic predisposition but anyone can be affected and there seems to be environmental triggers that are poorly understood.
“What we do know is that if it is not properly controlled, it increases the risk of heart disease, blindness and kidney failure in adulthood.
“It is extremely important to get it right. This is critical in childhood, where we are setting the child on a life-long journey in managing this condition.
“The aspiration should be that every child should have access to the same and the best standard of care, regardless of where they live.
“There is not equity in Ireland in access to a full diabetes multi-disciplinary team.
“Cork is the largest centre in Ireland without a dedicated psychologist to support these families. In addition to our local children, we provide diabetes expertise for children in Kerry and as far as Clonmel (Tipperary).
“Rather than bringing children long distances to us, appropriate staffing of the diabetes programme at Cork would allow our diabetes team to perform regional outreach clinics. In my view, that should be the model.
“That’s ultimately what we want to do in Cork, but we are very far from the staff numbers needed to care even for children at Cork at this stage.”
World Diabetes Day this year marks a century since insulin was discovered by a Canadian team.
People who would like to support the work of the paediatric diabetes team at CUH can donate at cuhcharity.ie.