People with Type 1 diabetes must attend hospitals for their specialized care but those in the Midwest region are unable to access their full care locally as there is no dietitian available. In 2018, the National Survey of Diabetes Care Delivery highlighted the 88% deficit in diabetes resources across all specialists in Limerick University Hospital Group.
That report stated that Limerick University Hospital Group should have 5 Whole Time dietitians working in diabetes care but at that time, had NONE and 4.2 consultant endocrinologists but only had 0.5. One year later there is no improvement.
Limerick University Hospital have failed over 1900 of their patients by not taking action resulting in their failure to meet the clinical needs of some of their patients who must attend other hospitals and attempt to get care there.
People with Type 1 diabetes need specialist diabetes care to support their daily best self-management practices. A dietitian is essential in supporting the individual to know how the food they eat is affecting their blood glucose levels and how to adjust their sugar intake to meet daily needs. According to Recommendation 3.4 of the Adult Type 1 diabetes mellitus Guidelines launched by Minister Harris, June 2018, all people with Type 1 diabetes should complete structured diabetes education with a dietitian within 6 months of diagnosis and be offered carbohydrate counting – neither is happening for people with Type 1 diabetes attending the hospitals of the Limerick University Group.
Ms Clíona Ni Dhuibhir was diagnosed with Type 1 in Limerick University Hospital but never met a dietician or was offered any course there. It was only when she was admitted to St Vincent’s University Hospital 2 years later with liver issues that she met a dietitian. “ The diabetes team in St Vincent’s came and helped me improve my carb counting (which I started myself) even though I was not in St Vincent’s for anything diabetic related and they knew Limerick was handling my diabetic care and that I was really appreciative of the great care I did get in Limerick”.
The Business Manager of the Limerick University Hospital Group, Ms. Nora Barry confirmed that there is no dedicated diabetes dietitian and that people with Type 1 diabetes cannot access “pump therapy” there but will accept patients already established on pump therapy.
Dr Anna Clarke of Diabetes Ireland says “an official HSE document highlighted the 100% deficit in dietetic services in Limerick University hospital this time last year but no action has been taken. It is well recognised that lack of dietetic services result in poorer control by as much as 2% increase in HbA1c resulting in increased need for nephrology, cardiovascular and podiatry services. You can see this in the Limerick University Hospital Group where they have increased their nephrology and cardiovascular consultant posts to 5 yet there is only 0.5 consultant endocrinologist looking after people with Type 1 diabetes. Prevention of associated complications is paramount and without the proper resources, this cannot happen and will no doubt reduce the quality of life of a lot of people with type 1 diabetes. This is simply not acceptable”.
Diabetes Ireland are calling on local people, public representatives, media to bring this to the immediate attention of hospital management, the Health Service Executive and the Department of Health.