Parents fear loss of quality service for children with Type 1 diabetes attending University Hospital, Limerick.

Over the   last year, children’s diabetes services in University Hospital, Limerick have improved dramatically with the hospital’s appointment of a full time locum endocrinologist replacing the half -time post. The locum consultant was dedicated purely to diabetes care with no commitment to general accident and emergency cover or general paediatric medical care. The position was solely medical care for the 250 children with Type 1 diabetes which effectively increased the medical support fivefold for the year. Families were delighted to receive their quarterly medical appointments with the diabetes team and be able to access their care so easily.
Now parent’s fear that appointments will slip as the tenure of the locum consultant post comes to an end and the service reverts back to a half-time post with the normal commitments to general paediatrics. Ms Sweeney, Limerick Parents Support Group stated that “the additional half time post in Limerick has made a huge difference for children attending there both access to new technology and regular reviews.”
Children with Type 1 diabetes need three monthly review to ensure their growth and development and a part-time consultant cannot physically review 250 children attending the service four times a year. In addition, the part-time consultant is to be shared with Galway as part of the plans to implement the Type 1 Diabetes Model of Care for Under 5’s which was to see all children under five have access to insulin pump therapy, the optimal treatment for most young people with diabetes.
Mr. Saunders, whose 10 year son attends University Hospital, Limerick, was very impressed with the management response to addressing personnel shortages in the past year. He said that “the improvements have been tangible for our son as well as for all children attending. It is vital to build on rather than reverse recent gains. To reduce resources now as patient numbers continue to grow would be a severe blow to the health and morale of all who use and work in this service”
Dr Anna Clarke, Diabetes Ireland said “the Model of Care for Under 5’s plans were developed and published in 2012 so that all young people with Type 1 diabetes could get access to latest technology with initial focus on the under 5 age group. At minimum, Limerick and Galway need a part time post in each hospital to support this. Cutting the Limerick Service medical support to a fifth will put children’s health at risk on a daily basis and we end up spending more on inpatient treatment and long term complications. Our children deserve better”.
Diabetes Ireland are calling on local T D’s to bring this to the immediate attention of hospital management, the Health Service Executive and the Department of Health. 

Editors notes
For more information contact: Dr Anna Clarke, Diabetes Ireland, telephone 01 842 8111
Background notes
Ireland is now confirmed as a high risk area for the development of Type 1 diabetes in our young population. Incidence of Type 1 diabetes has increased with a younger age of susceptibility. Four children a week are being diagnosed with this lifelong condition which requires intensive medical and personal management to protect future health.
Type 1 diabetes is an autoimmune condition affecting the child’s ability to control the glucose level in the blood. Insulin is required regularly either as injections or continuous infusion (pump) which must be balanced to food intake and physical activity level. This requires education, motivation and ongoing support of the family from the specialist paediatric diabetes team.
The Facts
Type 1 diabetes can have a potentially devastating acute and long-term effect on a child or young person and their family.
It is well established that intensive diabetes management in a supportive environment reduces the risk of complications in later life.
The DCCT trial suggests that a reduction of 1.2% in HbA1c would translate to:

• 7% reduction in lower limb amputation.
• 10% reduction in myocardial infarction.
• 18% reduction in severe visual loss.
• 29% reduction in end stage renal disease and dialysis.

The goal of medical treatment for diabetes is to enable the patient to lead as normal a life as possible, free from adverse effects and complications for as long as possible.
International data support that the increase in the direct cost of providing quality diabetes care, is likely to be offset by a reduction in acute and chronic complications resulting in saved bed days and a reduction in the current 68% or diabetes health budget on costly diabetes complications.

Diabetes Ireland is the national charity dedicated to providing support, education and motivation to all people affected by diabetes. Diabetes Ireland also raises public awareness of diabetes and its symptoms and funds Irish-based research into diabetes.