Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

New diabetes research reveals uneven distribution of quality care for young people in Ireland with type-1 diabetes

14 November 2013

New research launched today to coincide with World Diabetes Day revealed that good quality care for young people with type-1 diabetes is unevenly distributed throughout Ireland. The research was carried out by the Royal College of Surgeons in Ireland (RCSI) and the Department of Sociology in University College Cork (UCC) and published this month in BMC Health Services Research journal.

Dr Diarmuid Smith, Consultant Endocrinologist, Beaumont Hospital said "Our research found that national austerity measures appear to be negatively impacting health services for young adults with type-1 diabetes in Ireland. There is a need for more doctors and diabetes nurses who specialise in the treatment of diabetes as well as allied health professionals to support diabetes patients in Ireland."

The research examined how young adults (aged 23 to 30 years of age) with type-1 diabetes and their healthcare providers feel about the quality of care delivered to young people with diabetes in Ireland. Interviews were carried out with 35 young people with type-1 diabetes and 13 healthcare professionals.

All interviewees felt that as a result of staffing problems stemming from recent government cuts in funding to the health services and from the historical underfunding of diabetes services the following problems existed:
* The waiting time to see healthcare professionals had increased in the past number of years
* Clinical visits were too short, frequently rushed with not enough time to discuss issues properly
* There was an over-reliance on junior doctors
* Continuity of care in the service provided was not optimal

The research also found that diabetes care was unevenly distributed throughout the country. Rural services appeared to be under-resourced such that they could not offer diabetes education programmes. Additionally diabetes technologies (insulin pumps/continuous subcutaneous insulin infusions) were only available from specialists' clinics meaning that young people from outside these clinics catchment areas had few opportunities to obtain these devices or had to travel long distances to obtain these services.

Dr Anna Clarke, Health Promotion and Research Manager, Diabetes Ireland said "Adults with type-1 diabetes are further victimised by the epidemic of type-2 diabetes. Already overflowing clinics are struggling to cope with the increased numbers resulting in people with type-1 diabetes not getting the appropriate number of health checks per annum and reduced time with healthcare professionals. This is especially evident in hospitals that do not hold designated type-1 clinics, generally rural areas where the numbers of people with type-1 diabetes is limited. This is further compounded by the lack of psychological support - a major requirement for all people living with a lifelong condition that face challenges to live with it on a regular basis."

The research found that both the young adults and the healthcare professionals identified many of the same problems with Irish diabetes services, but the healthcare professionals were more critical of the diabetes services than the young adults. Young adults generally expressed high levels of satisfaction with services, even where they noted that aspects of those services were below average. The young adults felt that although there were problems, the diabetes services were doing the best they could under the difficult circumstances.

The research can be viewed at http://www.biomedcentral.com/content/pdf/1472-6963-13-448.pdf

The study was funded by Diabetes Ireland, the Medical Research Charities Group and the Health Research Board.