Camillus Glynn (Fianna Fail)

Ba mhaith liom fáilte a chur roimh an Aire Stáit. I welcome the Minister of State, Deputy Áine Brady. I thank the Leader of the House for arranging for this debate at my request. On several occasions in the past, not just in this Seanad but in previous ones, I have sought a debate on types 1 and 2 diabetes. Having listened to colleagues on all sides of the House, it is clear that diabetes is regarded in a serious manner, and rightly so.

An elderly general practitioner told me if we could rid ourselves of the problem of diabetes we could close half of our hospitals. Many people might believe that to be a throw away remark, but there is much truth in it. Having in the past dealt in a professional capacity with diabetes I can say with much sincerity to this House that it is a huge problem. I know of three Members of the previous Seanad from this side of the House who were diabetics. Two of them have since passed to their eternal reward. They were the ones of whom we knew.

As regards heart disease, one quarter of all by-pass operations are carried out on people who have diabetes. Diabetes is the primary cause of kidney failure and the commonest cause of blindness in people aged under 65. People who have been diabetic for any length of time will say they have great problems with their sight. Conditions such as gangrene of the lower limbs, the loss of toes, feet and legs are not uncommon. Diabetes is the primary cause of lower limb amputations.

A friend who is a consultant physician revealed to me today the startling statistic that 20% of people attending his outpatient department are diabetics. Another startling statistic is that a person with diabetes is five times more likely than a person who does not have diabetes to suffer a stroke or die from a heart attack. They are frightening statistics. It is said that for every type I diabetic diagnosed one or two go undiagnosed.

When a member of the Midland Health Board in the early 1980s a grand nephew of mine, then ten years old, was diagnosed as a type I diabetic. He was at that time one of ten newly diagnosed diabetics in the medical ward of Mullingar Regional Hospital. When I asked the director of community care if the incidence of diabetes was on the increase or if it was the case that we had better diagnostic facilities than was previously the case, he told me we had better diagnostic facilities. That information was incorrect because the incidence of diabetes has increased and had even at that time increased, which is in excess of 20 years ago.

Much has been said about lifestyle. Lifestyle has an integral role to play in this area and exercise is extremely important. There is common reference to obesity diabetes. Fatty foods such as crisps and fizzy drinks are considered causation factors in type II diabetes.

The national diabetes programme was established under the governance of the quality and clinical care directorate of the Health Service Executive to progress a national diabetes plan. The plan has five key objectives: to establish a national diabetic retinopathy screening service, to establish a national diabetes register, to progress footcare services nationally, to facilitate integration of diabetic services between primary and secondary care and to develop strategies to improve diabetic control and risk reduction to prevent diabetic complications. A campaign is currently underway to improve podiatry services, which I strongly support. I warmly congratulate the Diabetes Federation of Ireland which is doing fantastic work. It is as always in the process of lobbying. Successful lobbying is lobbying again and again and, when one gets tired, lobbying again. In other words, one does not stop. This problem has such serious implications for public health, our hospital services and health resources that something must be done to ensure it is brought under control.

A national screening programme was mentioned, a worthy proposal. As mentioned by a former colleague, men are the world's worst in terms of looking after their health. It is usually at the insistence of a man's wife, partner, sister, daughter or a female friend that he goes to the doctor. Very rarely do men take action on their own initiative. What is strange is that men will have their cars serviced regularly but will not look after their own health.

A podiatry service is extremely important. I ask that the Minister of State, Deputy Brady, have due regard, through her Department, to podiatry services. Appropriate podiatry services could save people many problems. We must examine how we utilise resources. Resources devolved to the provision of a better podiatry service will in the fullness of time result in people not having to have their toes, feet or legs amputated.