THE WORD tsunami, in the context of an irreversible future phenomenon, has possibly been overused when it comes to healthcare forecasting. Yet it is difficult to argue with its appropriateness where the significant rise in cases of diabetes on the island of Ireland is concerned.
Recent research carried out by the Institute of Public Health (IPH), in conjunction with health research centres at University College Cork and Queen’s University Belfast, projects the number of adults aged 45 and over with both diagnosed and undiagnosed diabetes will rise by 30 per cent to about 177,000 by 2020. In 2010 it was estimated that more than one in 10 adults 45 and over in the Republic had diabetes.
Diabetes is a chronic life-long condition. It causes damage to many other organs in the body and is a leading cause of blindness, kidney failure, heart attack and stroke. A 36 per cent rise in strokes among people with diabetes has been recorded since 2006. For kidney failure, the 2010 rate was 62 per cent higher than 2006 with more than 4,300 people with diabetes being treated in hospital for kidney failure that year.
Such increases put tremendous strain on existing health services, especially in the context of a projected health budget deficit of €500 million by year end. Despite a Health Service Executive commitment to an integrated model of care for people with the condition, progress in implementing specific clinical programmes has been slow. Although a screening programme for eye disease is scheduled to be available by the end of this year, a programme designed to move the care of most people with diabetes to general practice has been inexplicably delayed.
There is an urgent need for policymakers and service providers to recommit to prevention initiatives for diabetes. Indeed, prevention of the disease is inextricably linked with that of obesity; some 80 per cent of those diagnosed with type 2 diabetes are overweight.
And where once this type of diabetes was a condition of older age, there is a growing trend whereby the condition is now being diagnosed in obese young people in their early twenties.
Current Government spending of almost 6 per cent of the total health budget on the complications of diabetes can only be contained by investing in prevention initiatives for both obesity and diabetes.
This requires a policy shift away from commendable cardiovascular and other strategies to an intense focus on practical initiatives at local community level.