Just 10% of people with type 1 diabetes in Ireland currently use an insulin pump and this is largely due to a lack of standardised care in the health service, new research has shown.
An insulin pump is a small device that is worn externally on the body. It delivers insulin without the need for a syringe or pen. Insulin pump therapy is recommended as a first-choice therapy for pre-school children and is considered beneficial for people with type 1 diabetes of all ages.
Researchers at the Royal College of Surgeons (RCSI) set out to determine possible barriers to using insulin pump therapy. Previous research by the RCSI found that just 10.5% of people with type 1 diabetes in Ireland use a pump compared to an average uptake in Nordic, central and western countries of 15-20%.
Major regional disparities were also found, with uptake among adults in Roscommon at just 2% compared to 9.6% in Kildare. Meanwhile, one-third of adult clinics, usually in rural areas, did not offer any type of insulin pump therapy support.
This latest research from the RCSI found a number of reasons for this, including lack of awareness among people with diabetes and a lack of standardised care nationwide.
In order to identify the reasons for lower uptake in Ireland, the researchers carried out 21 interviews and four focus groups among people with type 1 diabetes, healthcare professionals and other key stakeholders.
They found that if the structure of the health service is insufficient, the quality of care is not standardised and capacity is poor, the uptake of insulin pump therapy is more reliant on an individual's interest, leadership skills, willingness and motivation.
"These factors may make the regional differences in accessing diabetes-related technology and the quality of care more evident," commented the study's lead author, Dr Katarzyna Gajewska, of the RCSI.
She said that solutions are needed to reduce the disparities in health service provision and the results of this study may inform healthcare professionals and policy makers in relation to gaps in the delivery of diabetes care.
"Such steps may include the development of national guidelines, models of care, and structured approaches to provide equal access to insulin pump therapy across the country," Dr Gajewska added.
Details of these findings are published in the journal, Acta Diabetologica.
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