The care of children with diabetes in Ireland should be ‘regionalised', despite the fact that this will result in some children having to travel further distances for their appointments, doctors have said.

They have carried out the first detailed study of the state of diabetes services for children with type 1 diabetes in this country.

Type 1 diabetes is an autoimmune condition, not related to weight or a sedentary lifestyle. It is not preventable or reversible and is most commonly diagnosed in childhood. Around 19,000 people in Ireland are affected.

According to doctors from Temple Street Children's Hospital, the incidence of this condition is higher in Ireland, the UK and Scandinavia compared to most of central and southern Europe. Furthermore, prevalence is on the increase particularly among children under the age of five.

The study identified 19 centres nationwide which deal with children with type 1 diabetes. Just over 2,500 children were attending these centres.

The doctors found that just one of these 19 centres had the appropriate diabetes nurse specialist to patient ratio that is currently recommended - 70-100 patients per diabetes nurse. However, that centre did not have a dedicated paediatric diabetes nurse specialist.

The doctors also noted that just one-fifth of the diabetes centres had guidelines in place for the management of children who fail to attend diabetes clinics regularly, those who have persistently poor glycaemic (blood sugar) control or teenagers who are transitioning to adult care.

"The data presented in the study highlight significant deficiencies across multidisciplinary teams in Ireland. It has previously been identified that many consultants delivering paediatric diabetes care in the Republic of Ireland as part of their general paediatric workload may not have specific training and ongoing continuing medical education in paediatric diabetes.

"Many services have insufficient diabetes nurses and dieticians and poor access to psychosocial services," the study noted.

The doctors emphasised that in order for high quality care to be delivered, adequately trained and staffed multidisciplinary teams are required. However, it may be ‘infeasible to provide this multidisciplinary care in smaller centres without sufficient patient numbers to justify the resource'.

"Regionalising diabetes care for children with type 1 diabetes should be considered," they insisted.

They pointed out that large patient numbers are needed to justify the full-time employment of a big multidisciplinary team.

However, they noted that while patient outcomes may improve if such ‘regionalising' took place, this would involve some patients having to travel to appointments and ‘careful geographic consideration of location centres is required to mitigate the burden for families'.

Details of these findings are published in the Irish Medical Journal.