Experts have welcomed the long-awaited national diabetes strategy but stress that what is pledged must be implemented within reasonable set targets.
Diabetes nurse specialist Moira Grixti expressed her satisfaction with the strategy, commending the proposal to introduce two new treatments – gliptins and repaglinide – to the approved government medicine list.
Difficulties with access to treatment was highlighted as an issue which often causes delays.
The strategy recommends that analogue insulin – currently available for Type 1 diabetes – be introduced for all type of diabetes, concurrent with a reduction in bureaucracy in the current entitlement protocols. Currently, Ms Grixti explained, Type 1 patients who are over 16 years of age must wait for six months before they are supplied with this form of insulin.
The strategy also recommends the introduction of innovative services such as an insulin pumps, Ms Grixti continued.
“What we need is an increase in human resources and in training. For instance, at the moment, there are only two diabetes practice nurses looking after Malta and Gozo. We’re on our own so we can’t reach everybody.
“Psychologists and multidisciplinary teams are also very important.”
Ms Grixti added that she would also like to see an increase in blood glucose strips, used to monitor blood sugar levels.
At the moment, there are only two diabetes practice nurses looking after Malta and Gozo
Chris Delicata, the vice-president of the Maltese Diabetes Association, said the benefits of the structured plan would hopefully reduce the personal, family and societal burden of diabetes. He also welcomed structured screening programmes targeting those most at risk.
The strategy promotes an ‘opportunistic’ screening programme for patients who are not necessarily showing related clinical conditions, in order to decrease the rate of undiagnosed diabetes.
This would be done in partnership with GPs, outpatient clinics, pharmacies and dental clinics.
“We must invest in multi-disciplinary teams that could be of service to persons living with diabetes and those who are at risk,” Mr Delicata told this newspaper.
“These include diabetologists, nurses with specialisation in diabetes, dieticians, psychologists and the like. We must also continue investing in new and innovative treatments and devices that are already available in other EU countries to ensure that we are providing Maltese citizens with the best possible devices and treatment to manage their diabetes.
“It is also important that what is pledged in the plan is implemented within reasonable set targets and which are all financially viable. We now have a strategy that is clearly outlined – therefore there is need to constantly monitor the implementation process to ensure that the priorities set out are delivered.”
The strategy followed a report drafted by the Parliamentary Working Group for Diabetes, chaired by former health minister Godfrey Farrugia and set up on the initiative of Opposition leader Simon Busuttil.
Key points of the 2016-2020 strategy:
• Increase awareness and literacy about diabetes.
• Provision of education and support for staff in schools in identifying and dealing with diabetes emergencies.
• Establish a pre-dialysis clinic with education and support through a multi-disciplinary team.
• Set up a specialist diabetes service in Gozo, achieved with the development of the Gozo Health Hub.
• Set up a high quality electronic health record for all patients with diabetes as part of the national health ICT infrastructure.
• Introduce a call and recall system for setting appointments for eye and foot screening.
• Recruit professionals so as to bring the staff complement for the paediatric diabetes service in line with internationally recognised levels.
• Children with diabetes will henceforth be started immediately on an insulin analogue if this is deemed the best clinical option for that particular individual.
• Carry out a detailed impact assessment of developing an insulin pump service.
• Establish a joint transition care clinic for adolescents with diabetes to move seamlessly from paediatric to adult services.