Anxiety and depression are twice as common among people with diabetes compared with the general population, according to a new report which recommends the introduction of increased primary care schemes for diabetics.
A University College Cork (UCC) study of some 2,000 patients with type I and type II diabetes has found that 28 per cent of patients reported mild to severe levels of anxiety and 20 per cent reported similar levels of depression.
Smokers and those with diabetes complications were worst affected. Women were also found to be more anxious than men, according to Prof Ivan Perry, a public health expert with UCC whose research on diabetes has been funded by the HRB.
He warns that being diagnosed with diabetes can add significantly to stress and anxiety levels, something of which patients, family and friends should be aware.
Patients' primary concerns centred on being able to work in the future or enjoy a meal and a drink. According to the survey, those who were well off and married with health insurance and a job enjoyed the best "quality of life" scores.
Older people scored higher than young people, while those who have to take daily insulin injections scored lowest.
The results have led Perry to recommend that patients with diabetes should be screened for depression and anxiety when undergoing other routine tests.
He acknowledges, however, that "resource issues" could hamper the introduction of such screening processes.
The patients surveyed by NUI Galway attended three different diabetes care teams, inclusive of a traditional hospital-led scheme in the southwest; a hospital/GP shared care scheme in Dublin; and a primary care scheme in the midlands.
Perry says that amid concerns that the numbers suffering from diabetes could double over the course of 20 or 25 years, a new and different style of care needs to be organised at GP level.
Currently, an estimated 210,000 people suffer from diabetes in the Republic, representing a ratio of one in 20 people with the condition.
A multidisciplinary primary care team on a localised basis would comprise a specialist diabetes liaison nurse with expert resources such as dietitians, ophthalmologists and chiropodists shared among the participating GP clinics.
In effect, the structured GP care could have obvious benefits for people in rural areas, according to Perry, who says the scheme could be as effective as a hospital team.
"We shouldn't assume the care has to be hospital-led. Primary care is at least as good, possibly better, and there is less travelling for patients," he says.
The model of care has already been implemented by the Midlands primary care team over a decade ago when there was no endocrinologist for the areas of Laois, Offaly, Longford and Westmeath.