I propose to take Questions Nos. 10, 34 and 70 together.
There are two main types of diabetes mellitus. Type 1, or insulin dependent diabetes mellitus, accounts for approximately 10% of patients and affects mainly young people. Type 2, or non-insulin dependent diabetes mellitus, accounts for 90% of all cases and affects mainly middle-aged or elderly people.
Patients with diabetes mellitus are diagnosed and treated in a number of different settings within the health services. The majority of patients, particularly those with type 2 diabetes, receive their treatment at primary care level. Other patients, particularly those with type 1 diabetes, receive their care primarily in the hospital setting, usually from a physician with a special interest in diabetes or, in rarer situations, from an endocrinologist who specialises in the treatment of diabetes.
Children diagnosed with diabetes usually require hospital admission for the medical management of their acute condition and the commencement of their diabetes education. Acute centres that provide diabetes care for infants, children and adolescents are outlined in the following table:
Health Board/Authority
|
Hospital
|
Eastern Regional Health Authority
|
Beaumont Hospital; Mater Hospital; St. Columcille’s Hospital, Loughlinstown; St. James’s Hospital; St. Vincent’s University Hospital; Adelaide and Meath Hospital, incorporating the National Childrens Hospital at Tallaght; Children’s University Hospital, Temple Street.
|
Midland Health Board
|
Midland Regional Hospital at Portlaoise; Midland Regional Hospital at Mullingar.
|
North Eastern Health Board
|
Our Lady of Lourdes Hospital, Drogheda; Cavan General Hospital.
|
North Western Health Board
|
Letterkenny General Hospital; Sligo General Hospital.
|
South Eastern Health Board
|
St. Joseph’s Hospital, Clonmel; St. Luke’s Hospital, Kilkenny; Waterford Regional Hospital; Wexford Regional Hospital.
|
Southern Health Board
|
Bon Secours Hospital, Cork; Cork University Hospital; South Infirmary Hospital, Cork; Tralee General Hospital.
|
Western Health Board
|
University College Hospital, Galway; Mayo General Hospital.
|
Mid-Western Health Board
|
Limerick Regional Hospital.
|
I recognise there is a need to expand and improve service provision to meet increasing demand. After detailed consideration and having had a series of meetings with the Diabetes Federation of Ireland to consider its strategy document, Diabetes Care: Securing the Future, I have asked the chief medical officer of my Department to chair a working group on diabetes. This group is charged with formulating a national framework for the future development and delivery of services for the increasing number of diabetics, including children, who require treatment. The group has been asked to examine the current and predicted epidemiology of diabetes, health promotion and preventative initiatives, including screening, current service provision, including the need to achieve better integration of care using current resources and facilities and the expansion of shared care programmes and future needs in terms of service provision and staffing.
Future planning in the care of diabetic patients will be informed by the recommendations of the working group which has been asked to report this year.