Expert warns of rising levels of diabetes

Patients must take responsibility in managing their condition if rising levels of diabetes type II - the most dangerous form of the disease - are to be controlled, a leading Irish specialist in the area has said.

"People with diabetes will have to acknowledge and understand their condition, make the lifestyle changes that are required and have the motivation to keep up these lifestyle changes," said Dr Tony O'Sullivan, a Dublin-based GP and chairman of the Diabetes Federation of Ireland (DFI).

Dr O'Sullivan also called for a patient-centred approach to diabetes care. He said there was a huge variation in the quality of care and access to care for people with diabetes. "Currently, we are only paying lip service to patient-centred healthcare. A patient-centred approach improves patient compliance, reduces complications and improves quality of life," he said. "We must consider that people are dealing with the disease 90 per cent of the time alone so we have to give them the psychological support to do this effectively."

He is, however, hopeful that the new diabetes expert group which will work with the HSE will give diabetics in Ireland opportunities to influence how future services develop.

Diabetes type II is a complex condition, caused by reduced insulin production. However, it can remain symptom-free for several years. The number of people with diabetes type II is expected to double within 20 years. Rising levels of obesity are strongly associated with such an increase yet a Finnish study found that with 30 minutes' exercise a day and improved nutrition, a group of overweight people reduced their risk of getting diabetes type II by 58 per cent.

"The Finnish study identified people in a pre-diabetes state [ with abnormal blood sugar levels] and found that their rate of developing diabetes could be reduced by two-thirds," said Dr O'Sullivan.

"If we don't respond to evidence like this, we are consigning the people who have the risk of developing diabetes to failure," he added.

If lifestyle issues are not adequately addressed, those with diabetes can go on to develop a number of complications ranging from heart disease to blindness to kidney problems and nerve disorders. There are medications to keep such complications at bay but not to reverse the declining levels of insulin.

Dr Michaela Diamant, from the VU University Medical Centre, Amsterdam, said: "It is difficult to motivate people to take eight to 14 pills a day when they don't feel symptoms of their condition."

Both Dr Diamant and Dr O'Sullivan were speaking at a special session on diabetes at the World Ageing and Generations congress in St Gallen, Switzerland.