GPs launch care initiative to deal with epidemic of adult diabetes

The Irish College of General Practitioners has taken a new initiative to confront the diabetes epidemic, as the number of people…

The Irish College of General Practitioners has taken a new initiative to confront the diabetes epidemic, as the number of people with the condition is expected to double by 2010.

More than 80,000 people in the Republic have diabetes, and 90 per cent of them have Type II of the disease, which is the adult non-insulin-dependent type. The age of onset has been falling, as modern diet and lifestyle have caused an epidemic among teenagers and young adults.

Diabetes is a manageable disease, but only with early detection and continuing care, according to the ICGP.

New clinical guidelines on the management of the disease were given at its annual scientific meeting in Dublin on Saturday, and the association has also drawn up plans for diabetes training for practice staff.

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Dr Tony O'Sullivan, director of the ICGP diabetes task group, called on all health board chiefs to appoint an individual or groups to deal with diabetic care developments.

Dr O'Sullivan, who has diabetes himself, said: "There are a lot of exciting new developments in diabetes, and we can expect a cure very soon. Meanwhile, we need to provide the best care we can."

Under the new guidelines diabetics will be offered the option of "shared care", with most clinic visits to the family doctor and only one hospital visit a year instead of four or more which is the norm at present.

Type II diabetes is treated using diet and tablets and does not usually require insulin therapy. It is ideally managed by "shared care" schemes. These are in place in several Dublin areas and the midlands and are planned for Cork and Kilkenny.

As 80 per cent of expenditure on diabetic care is spent on managing complications of the disease and with half of the people with diabetes dying from premature heart disease, the ICGP says it is time to change how services are delivered.

The meeting also debated "Litigation - is it good for us?" It heard calls from doctor and patient representatives for a separate independent mediation service for complaints about doctors' performance.

Doctors expressed frustrations at the pressure they feel to practise "defensive medicine", with a view to defending themselves in court in the future, as recent legal decisions seemed to suggest that a reasonable standard of care was no longer an adequate defence.

Patients' representatives said many legal cases against doctors were about seeking a proper explanation of what went wrong with medical treatment, and if explanations were given early many such cases would not be pursued.