Chronic Shortage of Diabetic Nurses

national | eu | news report Saturday March 25, 2006 16:50 by Kathy Sinnott

Last week in the European Parliament we voted strongly to eliminate Mercury from our food, air, water and soil in as far as we can. Of course deciding to do it and doing it are different things but it is a start and I am hopeful that even if the elimination is not complete, people will at least benefit from a reduction. In California, thermerisol which contains mercury has been removed from pediatric vaccines. As the children who got thermerisol free vaccines are reaching preschool age, the state is reporting the first slowing down of the rate of increase in the numbers of children becoming autistic.

Mercury is a start. But considering the epidemic levels in so many conditions, we have a long way to go in eliminating the environmental hits, whether foods, poisons or practices to which we and especially the children among us are exposed.

One of the conditions that are increasing rapidly is diabetes especially in children. Considering the rarity of diabetes in childhood 30 years ago it is tragic to watch the numbers of children affected double every few years. A parliamentarian from Mauritius has said that since his country abandoned other crops and devoted itself almost entirely to growing sugar cane the rate of diabetes has spiraled. Consuming sugar may be a factor in some cases but it doesn’t explain diabetes in an 18 month old baby.

Looking at family medical history there are conditions that regularly repeat in the generations but diabetes was not one of them. Now I have six relations with diabetes most of them with juvenile onset, Type 1 (total insulin dependence) diabetes.

Recent success in treating diabetes with adult stem cells (the patients own stem cells) is very exciting but it’s very early days. I would like to think that there are scientists tirelessly searching for the causes of all these new cases of diabetes so we can prevent any more children from being affected but this is not happening fast. The reality of diabetes is that the urgencies of the disease itself demand that we have to concentrate resources on the treatment of those who have already developed it.

People with diabetes and their families need very definite things. Insulin by pump, injection or tablet depending on the person and their insulin needs, the means to check their blood sugar levels, regular and emergency medical monitoring and management services, proper training in self management and a modified diet. If they get these essentials they can deal with their diabetes and stay healthy. Without these things they risk vision and heart problems, kidney failure, amputation and life itself.

It is a non negotiable check list. Every one in the field of diabetes knows it by heart yet we have a real problem in the Southern HSE. Not all the items are there for all the people with diabetes. Further, even with dangerous gaps in the essentials, our health authorities seem unwilling to provide improved equipment like insulin pumps and glucometers. The problem is money - or at least the allocation of money.

When it comes to the professionals, the problem is not with the excellent and dedicated medical professionals that are in place in this Health authority area but the ones that are not in place for want of sanctioned posts. The southern HSE does not seem to realise that the number of children diagnosed with diabetes in Cork University Hospital catchment area has doubled in the last 3 years.

To give an idea of the problem in Cork there is a half diabetes nurse post for 250 people with diabetes. To be effective there should be one nurse to 75.

What difference does it make? One evening Daniel’s parents heard, him crying. He had settled in bed and they were surprised he was not asleep. By the time they got to the bedroom door he was in hysterics. Daniel, almost 2 years old at the time had been diagnosed with diabetes 3 months previously.

Daniel’s parents were still new to diabetes and this was the first time they had seen him like this. As they had been told to do, they rang the hospital diabetes advisory service No one was there or rather the two and a half needed but not sanctioned special diabetes nurses were not there. The sanctioned half nurse was not on duty. Eventually Daniel’s desperate parent were connected to someone at the hospital who knew even less about diabetes than they did. Hanging up the phone they had to follow instinct.

What difference does lack of specialized staff make? It can be life and health threatening.

A lot can go wrong with diabetes especially in children because they are growing and changing and get into all manner of scraps and scrapes and goodies. Every up and down, the stuff of childhood requires an adjustment in insulin for children whose pancreas is not making those adjustments automatically. Keeping diabetic damage at bay depends on having good management.

Good management especially in a child largely depends on committed parents with expert professional support. In Cork we have plenty of the first and not enough of the second. It’s a no-brainer that we need the Minister for Health to commit more money to diabetes services and to sanction more posts.

In Strasbourg last week I listened to Irish representatives proudly tell visiting university students about the Irish economic miracle, I hear it all the time and quite frankly I find it hard to take. I wonder if any of the students had diabetes - if any of them felt as I did. And I wonder if a factor in our economic miracle is that we don’t spend enough on our people.

Public meeting of the Parents Support Group, Cork Branch of the Irish Diabetes Foundation, Monday April 4th, Metropole Hotel, Cork. All Welcome.