Serious shortcomings in medical services for people with diabetes in the Western Health Board (WHB) area have been highlighted in a report which found staffing levels were only one-tenth of those recommended.
Compiled by the Diabetes Service Review Group, the report calls for an increase in staff to provide a more comprehensive diabetes service in the region. It also recommends the establishment of a diabetes daycentre for the region at University College Hospital, Galway, and for diabetes units to be set up to cover east Galway, Roscommon and Mayo.
Diabetes mellitus is a major cause of ill health and death and is one of the five leading causes of death by disease in most developed countries, including Ireland.
The most recent figures show that 4,887 people, or 1.4 per cent of the region's population, have diabetes, but this is considered an underestimate.
The Diabetes Service Review Group was set up to review services for people with diabetes in the west and to make recommendations for improvements.
Their report, which has not yet gone before board members for discussion, states that staffing levels are inadequate for the provision of a multidisciplinary, high-quality service.
There are insufficient numbers of dietitians in the region, the report states, and an over-reliance on the ability of junior hospital doctors to provide eye-screening. Inadequate screening means referrals to the consultant ophthalmic surgeon often occur when complications are advanced.
"There is no combined diabetic and ophthalmic clinic in existence in the Board's area. The screening model found in Portiuncula Hospital where community ophthalmologists provide dedicated clinics for people with diabetes is felt to be effective," the report states.
It recommends that internationally recognised ratios of personnel to population be adopted and that the WHB appoint a dedicated endocrinologist at UCHG, three extra consultants with a special interest in diabetes, three more full-time diabetes nurse specialists, three full-time dietitians and three full-time chiropodists, as well as additional support staff.
Dr John O'Donnell, the only consultant endocrinologist in Galway at the moment, was a member of the Diabetes Review Group and involved in the compilation of the report. He described diabetes services in the WHB area as "restricted" but said he was optimistic they would be expanded soon.
One of the most important first steps in improving services was to develop a diabetes day centre at UCHG and to provide extra nursing staff and dietitians. Although such centres are scarce in Ireland, he said, the idea had been around for some time.
The WHB's director of public health, Dr Mary Hynes, said the report was not yet board policy but she was hopeful the general thrust of its recommendations would be taken on. Given the scale of investment involved, improvements to the service would be gradual, she said.
