Diabetes care lacking in the mid west

No dietitians available despite recommendations
  • Deborah Condon

People living with type 1 diabetes in the mid west of the country are not getting the full range of specialised care that they need, due to a lack of dietitians, Diabetes Ireland was warned.

People with Type 1 diabetes require specialist care to support the self-management of the condition and dietitians play a key role in this.

Dietitians are the only qualified health professionals that assess, diagnose and treat dietary and nutritional problems. They use the most up-to-date public health and scientific research on food, health and disease, which they translate into practical guidance to enable people to make appropriate lifestyle and food choices.

When it comes to diabetes, dietitians provide essential education on how foods affect blood glucose levels, and how to adjust sugar intake to meet daily needs.

Last year, the National Survey of Diabetes Care Delivery highlighted an 88% deficit in diabetes resources across all specialists in the Limerick University Hospitals Group, which is made up of six hospitals in the region.

According to that report, this hospital group should have five whole time dietitians working in diabetes care, but at that time, it had none.

"One year later, there is no improvement. Limerick University Hospital has failed over 1,900 of their patients by not taking action, resulting in their failure to meet the clinical needs of some of their patients who must attend other hospitals and attempt to get care there," Diabetes Ireland said.

The charity pointed out that according to a recommendation in the Adult Type 1 Diabetes Mellitus Guidelines, which were launched by the Minister for Health in June 2018, all people with type 1 diabetes should complete structured diabetes education with a dietitian within six months of diagnosis. They should also be offered carbohydrate counting.

However, neither is happening for people with type 1 diabetes who are attending the hospitals of the Limerick University Hospitals Group.

Clíona Ni Dhuibhir was diagnosed with type 1 diabetes in Limerick University Hospital, but never met a dietitian or was offered any nutrition guidance there. It was only when she was admitted to St Vincent's University Hospital in Dublin two years later with liver issues that she met a dietitian.

"The diabetes team in St Vincent's came and helped me improve my carb counting, which I had started myself, even though I was not in St Vincent's for anything diabetic related, and they knew Limerick was handling my diabetic care and that I was really appreciative of the great care I did get in Limerick," she explained.

Meanwhile, Diabetes Ireland also pointed out that the Limerick University Hospitals Group should have at least four whole time consultant endocrinologists, but currently only has one part-time consultant.

Furthermore, the business manager of the hospitals group, Nora Barry, has confirmed that people with type 1 diabetes cannot access ‘pump therapy' there, however the group will accept patients already established on pump therapy.

"An official HSE document highlighted the 100% deficit in dietetic services in Limerick University Hospital this time last year, but no action has been taken. It is well recognised that a lack of dietetic services results in poorer diabetes control, resulting in an increased need for nephrology, cardiovascular
and podiatry services," commented Dr Anna Clarke of Diabetes Ireland.

She emphasised that the prevention of diabetes-related complications is "paramount" and without the proper resources, "this cannot happen and will no doubt reduce the quality of life of a lot of people with type 1 diabetes".

"This is simply not acceptable," Dr Clarke added.

Diabetes Ireland is calling on local people, public representatives and the media to bring this to the immediate attention of hospital management, the HSE and the Department of Health.

For more information on Diabetes Ireland, click here.


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