Concern on VHI diabetes screen plan

  • Niall Hunter, Editor

The support body for people with diabetes is concerned about a new scheme to detect the disease which will be available to VHI members in the catchment areas of two Dublin hospitals.

The Diabetes Federation of Ireland is to meet VHI on January 20 to discuss the screening scheme, amid concerns about whether GPs and hospitals will have the resources to cope with the thousands of additional cases of diabetes it is likely to detect.

VHI is to screen for type 2 diabetes 57,000 of its members between the ages of 45 and 75 who live within a five kilometre radius of either St James's or the Mater Hospitals in Dublin.

The VHI's Medical Director, Dr Bernadette Carr, told that the selected patients are initially being invited to fill out a questionnnaire about their lifestyle and health.

They will then be invited to bring in the questionnaire when they attend their local hospitals for screening, which will include blood sugar-testing, lipid-checking, body-mass index measurement and if necessary an oral glucose tolerance test.

The screening is being carried out by qualified nurses under the direction of a specialist physician at the VHI's Corporate Solutions Centre in Dublin 12, in accordance with protocols based on latest clincial guidelines drawn up in association with the medical teaching units at the two Dublin hopsitals, according to VHI.

She said the results of the testing should determine whether people have type 2 diabetes or 'pre-diabetes' and these will sent to the patients' GPs so that a suitable treatment programme can be initiated.

Dr Carr said to date VHI had to date mainly been focused on treating patients when they become ill; however there was also a need to prevent chronic illnesses developing or exacerbating through early detection programmes.

She said many people with type 2 diabetes did not know they had the condition which is very much a "silent disease."

However, if left untreated, it can lead to major complications such as eye disease often leading to blindness, foot ulcers, heart conditions and kidney disease, she pointed out.

It is believed that as many as 200,000 people in this country have type 2 diabetes and 100,000 more may be at risk of getting the disease.

Dr Carr said screening programme aimed at detecting diabetes early can lead to savings in overall healthcare costs arising from treating the many complications of the condition, in addition to improving the quality of life for people who can be effectively managed at an early a stage as possible.

Kieran O'Leary of the Diabetes Federation told that while they would welcome in principle any move to improve screening, they had concerns about the VHI programme and would be seeking clarification on it at a meeting with the insurance company on January 20.

He said hospitals and GPs  are under a lot of pressure at the moment and he would be concerned about the resource implications of the VHI scheme, which he said could pick up type 2 diabetes in around 5% of the 57,000 people due to be screened.

"We would be concerned about thousands of patients being added to the system in two specific areas of Dublin and what resources are being put in place to manage these new patients. We will also be seeking clarification on whether the newly-diagnosed patients will be managed in primary care or at hospital level and whether the patients will go into the private or the public system."

Mr O'Leary said the Federation would be willing to offer any assistance it can give to the VHI on the screening programme from the resources it has at its disposal.

Dr Carr said the screening programme was currently a pilot project confined to two areas. However, it could go nationwide to all VHI members depending on the results of the pilot.

Asked if the VHI scheme was not essentially discriminating against public patients in addition to private patients who were not VHI members, Dr Carr said it was a VHI initiative and as such they could only offer services to their own members.

She said while in the longer-term such screening programmes might be an initiative the public health system could consider providing, VHI could only be responsible for its own members.

She said the diabetes screening plan is being made available to members on all VHI plans in the age group and catchment areas concerned.



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