Camillus Glynn (Fianna Fail)

Cuirim fáilte roimh an Aire. I very much welcome this debate, which I have requested for the past two years.

I am exercised about this situation for several reasons. I come from a health background, and the number of acquaintances who have developed diabetes in recent years is astounding. Views differ regarding the figures, but those that I have been given by the Diabetes Federation of Ireland suggest that approximately 250,000 diabetics have been diagnosed in Ireland, 90% of them type 2. By 2020, that figure will rise to 350,000. The Minister of State's speech has been most informative, and he has certainly hit many of the right buttons, stating that the incidence of diabetes is on the increase.

Diabetes has been described by at least one media outlet as the silent epidemic, but it has great implications for the health services. I regret that to date much of what has been done has been reactive rather than proactive. I was glad to hear the Minister of State speak, and many of the measures that he outlined will improve the situation. The establishment of an expert advisory group is extremely welcome, and I strongly endorse the input of the Diabetes Federation of Ireland.

This condition has several factors, some of which the Minister of State has brought up. The old saying is that we are what we eat, and the food industry has a pivotal role. Kelloggs has certainly reduced the number of components in its food products that would allow this condition to develop. If we are to win this great battle, it cannot be a matter for the medical or nursing professions or the health services alone. This battle is faced by society as a whole, and it will be won only if everyone pulls his or her weight.

Reference has been made, perhaps not today but in the past, to people commenting that they have never been to a doctor in their lives and feel great. It is important to remember that many of them are of my gender, and while they will regularly bring their car for a service, they will not visit their GP for a check-up. That is regrettable, as proactive measures are the only way in which we will address this growing epidemic.

In my early days as a member of the Midland Health Board, a young member of my family aged perhaps ten was diagnosed as a diabetic, one of ten new diabetics in Mullingar General Hospital at the time. I asked the director of community care whether diabetes was on the increase or whether the diagnostic procedures were better. I was informed that the latter was true, but that while the incidence was increasing it had not been detected. GPs can do a great deal, and they are doing their best. They cannot send out well-trained collies or other teams to bring people to them. However, people should go to their GPs to get themselves screened. Schools can also play a very important role in the area.

The former Minister for Health and Children, Deputy Martin, in 2004 established a working group to examine the issue and make recommendations for further action. The group's work has been informed by a wide range of available evidence nationally and internationally, including a major document produced by the Diabetes Federation of Ireland entitled Securing the Future. The national diabetes working group submitted its report to the Tánaiste and Minister for Health and Children, Deputy Harney, last summer. It was forwarded to the chief executive of the Health Service Executive in October 2005, and the HSE is giving this matter priority. This topic arose last Thursday as my colleague across the floor and others, including Senators Kate Walsh and O'Meara, were present. The situation received a certain acknowledgement.

We must also take on board the fact that not all parts of the country have the services of a consultant endocrinologist. The midland region, where I happen to reside, is among those without one. As chairman of the Midland Health Board, I remember receiving a deputation with the then deputy CEO with responsibility for community services. The point was made that there was an urgent need for a consultant endocrinologist in the midland region. There are now dialysis services there, but we still require an endocrinologist.

Type 1 diabetes, formerly known as insulin-dependent diabetes, develops where there is a lack of insulin in the body because the cells that made it have been destroyed. That type of diabetes usually appears before the age of 40 and is treated by insulin injections and diet. The causes of type 1 diabetes are complex and still not clearly understood. People with type 1 diabetes are thought to have an inherited or genetic predisposition to the condition that may remain dormant until activated by an environmental trigger such as a virus or chemical. That starts an attack on the immune system that results in the eventual destruction of the beta cells in the pancreas and subsequent loss of insulin production.

Type 2 diabetes, formerly known as non-insulin-dependent, develops when the body can still make some insulin, although not enough for its needs, or when the insulin that the body makes is not used properly. We must examine exactly what people do to help themselves. As Senator Henry has said, we must also consider all the services, such as those that deal with problems with the eyes and feet. Statistics have proven that the most common reason for amputation of the lower limbs is type 1 diabetes. Blindness is also a major side-effect of diabetes. There are cardiology and kidney problems and a plethora of others driven by this condition.

The cost implications of this condition to the economy regarding what it will draw down from health services are mind-boggling, and I do not believe that anyone has realised that. This can only be resolved by all sections of society working together. This crisis rivals that of tuberculosis in the early part of the last century.