Deficiencies in national audit of services for children with Type 1 diabetes

Significant deficiencies have emerged in a national audit in services for children with Type 1 diabetes.

It showed many services have insufficient diabetes nurses and dieticians and poor access to psychosocial services. Just one of the 19 centres managing children with Type 1 diabetes had the recommended number of diabetic nurse specialists.

However, the centre did not have a dedicated paediatric diabetic nurse specialist.

There were 2,518 children attending the centres in 2012 and the study showed that many were being deprived of insulin pump therapy, with usage ranging from 0 to 42%.

Children with Type 1 diabetes need specialist care, ideally provided by a team with appropriate expertise in dealing with the condition that requires life-long insulin therapy.

However, the study by researchers at the Children’s University Hospital, Temple Street, Dublin, reveals a wide variation in the structure and process of care between centres.

With limited resources available, the authors say “regionalising diabetes care for children with Type 1 diabetes should be considered”.

Diabetes Ireland welcomed the report published in the latest issue of the Irish Medical Journal, saying it simply reiterated their understanding of the current state of diabetes paediatric care in Ireland.

It said every child and young adult should have access to insulin pump therapy, if clinically deemed to be beneficial.

Diabetes Ireland chief executive Kieran O’Leary said the audit confirmed children with Type 1 diabetes were not getting internationally recommended three-month reviews and it was a particular concern in the larger centres.

“While we do agree there needs to be regionalisation of services in areas of large geographical spread — such as in the north-west, Mayo, and Cork/Kerry — we do feel that outreach services from these centres of excellence to a local service will provide far greater support to families,” he said.

“We would also see GPs, trained in the management of rapid diagnosis and sick day management as being a vital cog in a structured service so that they can effectively look after routine illnesses in people with Type 1 diabetes.”

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