Care model could reduce diabetes amputations by a third

A new model of care for the management of type-2 diabetes by GPs and practise nurses will reduce amputations by a third.
Care model could reduce diabetes amputations by a third

The author of the new guidelines launched yesterday, Dr Velma Harkins, said proper diabetes management and foot care helped to prevent complications that could result in amputation.

Dr Harkins said in the past, the care of diabetes was unstructured and sometimes delivered in an opportunistic manner.

She said there had been an “explosion” in the prevalence of diabetes mellitus, predominantly type 2. It was forecast to increase by 62% between 2007 and 2020.

“If these guidelines from the Irish College of General Practitioners are followed, amputations will be reduced by a third,” said Dr Harkins.

“General practice which has continuity of care at its core is uniquely placed to ensure the flexibility to deal with the diverse demands of people at different stages of their disease.”

A structured care programme for diabetes that has been running in the Midlands for some time has delivered good results.

“We have been running the programme for nearly 25 years in the midlands and it has never been an issue for patients,” she said.

“Patients with diabetes 2 need regular ongoing care and it is not really possible to do that in a hospital setting.

“It is really about structuring their care so they get the best outcomes.”

Dr Harkins said there were about 190,000 people with diabetes in Ireland and 160,000 had type-2 diabetes.

Of the 160,000 with type-2 diabetes, 100,000 had their care managed by their GP while 60,000 attended hospital as well as their GP.

“It is totally the patients’ choice whether they want to have their diabetes managed by their GP or in a hospital setting.”

Dr Harkins said about 50% of patients with diabetes 2 being cared for by their GP would have a medical card and for those attending their GP privately it represented incredible value.

Dr Harkins said waiting lists for podiatry (foot) care had also improved, with a number of extra posts provided in the last few months.

Meanwhile, the Irish College of General Practitioners, said more GPs were needed just to “stand still”.

A spokesperson for the professional body for general practice in Ireland said the college trained 157 GPs a year and would have to train more.

He said the ICGP could safely train more GPs but would have to given a little bit of time and resources to do that.

Health Minister Leo Varadkar has admitted that training another 2,000 doctors between now and 2025 would not be realistic.

Government plans to introduce free GP care for the entire population have been dropped from the Fine Gael party’s manifesto.

The party will instead commit to all under 18s and older people with chronic illnesses availing of the scheme by 2020.

However, the Labour Party’s general election manifesto still promises to introduce free universal GP care for all, despite the lack of GPs.

Mr Varadkar said training another 1,000 GPs between now and 2025 was ambitious but training 2,000 more would not be realistic.

“We have a long history in this country of all political parties making very grand promises about health in the run up to an election and then not delivering them.”

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