Maria Corrigan (Fianna Fail)

I am pleased to have an opportunity to contribute to the debate and discuss the causes and effects of diabetes and, more important, the framework for the development of a retinopathy screening programme. I welcome the Minister of State, Deputy Áine Brady, and congratulate her on the new and important role conferred on her. I wish her well and have no doubt the competence she will bring to her areas of responsibility will be beneficial.

Diabetes affects people from all walks of life, from the very young to the very old, and is considered by the World Health Organisation to affect 246 million people worldwide. The WHO anticipates that the condition will affect 380 million people by 2025 if nothing is done to slow down the epidemic. In 2007, the International Diabetes Federation noted that the disease had caused 3.8 million deaths worldwide, accounting for approximately 6% of total global mortality. This stark figure places the issue in context as it shows the disease has caused roughly the same number of deaths as HIV-AIDS.

Diabetes can be prevented and its consequences minimised through good management. Early detection is, therefore, crucial. The establishment of programmes such as the national retinopathy detection programme will assist in this regard. It is estimated that approximately 200,000 people in Ireland suffer from diabetes, many of whom are unaware that they have the condition. As other speakers noted, the majority of diabetes sufferers will only be diagnosed when symptoms arise during an acute medical event arising from complications such as long-term, untreated hyperglycaemia. A further 200,000 people have impaired glucose intolerance or pre-diabetes and of this group, 40% will develop diabetes in the next five years if lifestyle changes are not made. In this respect, I was struck by comments made by Senators Walsh and Quinn on the impact lifestyle changes can have.

It is clear that detection and proper treatment are at the core of confronting the challenge diabetes presents in this country. A number of factors make people susceptible to type 2 diabetes. Obesity is one such factor. More than 80% of people with type 2 diabetes are overweight. This makes all the more relevant those programmes we have highlighted, notably in the past 18 months, on the importance of maintaining a healthy body weight and creating awareness of what constitutes obesity and fat levels in our body mass.

Age is another factor which increases susceptibility to type 2 diabetes. Between 90% and 95% of those with diabetes are aged over 40 years. Additional factors are a family history of diabetes and physical inactivity. The condition can also occur during pregnancy.

Given my background, the role emotional stress and anxiety can play in the onset of diabetes and in exacerbating the problem is of particular interest to me. People are living highly stressed lives leading to irregular and chaotic lifestyles. This is often evident in eating and physical exercise patterns. Furthermore, grief, worry, anxiety or the death of a close loved one can contribute to the alteration of blood sugar levels and result in the onset of the disease. In the present challenging economic times many Irish people are suffering from stress and anxiety as a result of the economic downturn, thus heightening the risk factors associated with the onset of diabetes.

In congratulating the Government on its continued commitment to mental health I urge that in these times of limited resources we carefully and specifically target expenditure to ensure it is spent most effectively on meeting the most prioritised needs.

I was struck by a further comment made by Senator Quinn concerning the importance of reminding people of what we can do. When people feel a loss of control and start to develop a sense of helplessness about their lives it can make a significant contribution to anxiety and stress. Identifying areas over which we have control is key to addressing this issue. For this reason, I endorse Senator Quinn's comments on the importance of having a programme of education to raise awareness of factors over which people can have control. It can assist in giving back a sense of control to people and give them the opportunity to identify areas of their lives for which they can take responsibility and manage. Practical information for people is very empowering.

Studies undertaken in the United Kingdom by the National Institute of Diabetes and Digestive and Kidney Disease and the diabetes trial unit at Oxford University have shown conclusively that effective control of blood glucose in an effort to keep the level as normal as possible is favourable in preventing and delaying the progression of complications of diabetes. The study further showed that there was a consequent 76% reduction in the risk of developing eye disease.

The Institute of Public Health published a report, Making Diabetes Count: What Does the Future Hold?, which provides the best possible estimate for the number of people both diagnosed and undiagnosed in Ireland today. It predicts there will be a 37% increase in diabetes in the Republic of Ireland over a ten year period. Dr. Kevin Balanda, the associate director of the IPH, predicted that the prevalence of diabetes in adults in 2015 will be 5.6% of the population or approximately 200,000 people. The vast majority of the increases in cases of diabetes is for type 2 and many of these will occur due to adolescent obesity and a lack of exercise, which are undoubtedly two of the most common causes of the epidemic of this disease.

I am conscious of stating the obvious, but adolescent obesity and a lack of exercise are factors within our control. When we consider the cost of diabetes, personally and economically, it makes sense to emphasise immediately the need to take back control of the factors over which we have control. Given the cost of diabetes on a personal level, the impact it has on a person's health and their quality of life — losing one's eyesight is very significant — and the economic cost to the State in meeting the needs of people who suffer those consequences, undoubtedly the retinopathy programme is money well spent. It is an investment in our people's health and our health service.

I welcome the adoption of the principles and continued roll out of the framework in the west. I ask the Minister of State to ensure a comprehensive system is put in place to evaluate the programme, that we then learn from that evaluation, make whatever adjustments are necessary and then roll out the programme in the rest of the country as soon as possible. This is something which will ultimately add to people's lives and will save the taxpayer and the Exchequer money in the long term.