IT IS CURRENTLY estimated that about 200,000 Irish people have type 2 diabetes, an illness which is preventable, yet has no cure and another 100,000 are at risk of getting it, writes Ronan McGreevy
Moreover, only half of those who have type 2 diabetes know they have the disease as it can manifest itself in symptoms which do not appear to be related to it such as heart conditions and bad circulation.
Two years ago, Prof John Nolan, a consultant endocrinologist at St James's Hospital, Dublin, reckoned that the cost of managing diagnosed and undiagnosed diabetes in Ireland was about €580 million a year. He described the treatment of diabetes as a "litmus test for our struggling health service".
Doctors estimate that 80 per cent of all type 2 diabetes cases could have been avoided if proper precautions were taken in relation to diet and exercise.
International research has found that losing less than a stone in weight can reduce the progression of diabetes by more than half.
With that in mind, VHI Healthcare will begin a pilot screening programme this month for type 2 diabetes for its 57,000 members between the ages of 45 and 75 who live within a 5km radius of either St James's Hospital or the Mater Hospital in Dublin.
The screening programme begins next Monday when the first 70 people will be tested.
"The reaction has been uninformly positive," said VHI medical director Dr Bernadette Carr. "If you can offer some support, most people are very positive about managing their health. This is a good opportunity for them to look at something for which they could be potentially at risk and what they can do about it."
Dr Carr said the prevalence of type 2 diabetes was a direct result of people living longer which was an unintended consequence of the success of treating diseases which would have killed people in previous generations.
Last year she told the Irish Hospital Consultants Association that the emphasis in healthcare needed to change from the treatment of acute diseases to the treatment and prevention of chronic diseases such as heart disease and diabetes.
"We believe in the 'stitch in time saves nine' approach. These are hugely expensive diseases to treat, but if you can check it early and manage it properly, you are significantly reducing the complications involved and that's where the costs incur."
Currently about 80 per cent of GP consultations and 60 per cent of hospital bed days are related to chronic diseases, a colossal drain on the health services.
VHI members, who sign up to the programme, will be offered free screening with fasting plasma glucose and, if indicated, a follow-up oral glucose tolerance test.
Participants will also be provided with a free fasting lipid profile, measurement of their blood pressure and BMI which, along with a medical questionnaire, will allow them to receive a report on their cardiovascular risk status.
Test results will be sent to both the member and to their general practitioner. If the pilot proves to be a success, it will be rolled out nationally in the future.
The imperative to save money has become more acute with Government cutbacks and the severe financial strain on the VHI which made a loss towards the end of last year.
The VHI has not revealed the costs of its screening programme, but estimates that it could potentially save a multiple of the costs involved if it can help prevent patients from developing the disease.
"There are finite resources in every health system, but, secondly, if you can prevent the complications that can occur, it makes an enormous difference to a person's life. It's a win win from everybody's point of view," said Dr Carr.
"People with type 2 diabetes can get a whole host of conditions. That includes heart disease, kidney disease, peripheral vascular disease in their legs and arms, neurological diseases and eyesight problems.
"These are all very major complications, but if you can get in early and prevent it or manage the blood sugar early on, you can prevent all the complications."