A “worrying” number of amputations are being carried out on people who were never diagnosed as being diabetic, according to the director of the Department of Health Information and Research.
“It is shocking that a number of amputations are being carried out on people whom we didn’t know had diabetes,” Neville Calleja said.
“This also happens with eye problems. It’s worrying. Doctors tell us they flip through the patient’s medical record and there is no indication that the person has diabetes.
“It is clear that, despite the services being offered, some people are slipping through the net and only receiving treatment for diabetes when their condition has deteriorated.”
It is clear that, despite the services being offered, some people are slipping through the net
Dr Calleja sat on the steering committee that drafted the public consultation document for the National Strategy for Diabetes 2015-2020, which was released yesterday.
Malta has the second highest percentage of diabetics in the Mediterranean, with about 33,000 adults known to be sufferers and another 8,000 adults thought to be undiagnosed.
The annual excess cost for hospital, primary care and specialist visits for people with diabetes in Malta in relation to those who do not have the condition is estimated to be at least €9 million, the bulk of which is due to more frequent and longer in-patient stays.
Research shows the average age of death for diabetics in Malta is 69 years for men and 79 for women compared with 77 and 82 respectively for non-diabetics. Health Parliamentary Secretary Chris Fearne said two-thirds of type 2 diabetes cases were preventable through lifestyle changes and by slashing obesity rates.
One of the challenges, he added, was broadening diabetes treatment so it is undertaken within the community by involving family doctors instead of solely at Mater Dei Hospital.
“However, wherever the treatment is given, it must be the same across the board,” he stressed.
Dr Calleja said the strategy aimed to implement measures to prevent diabetes, expand treatment options and improve integrated management of diabetes to prevent or postpone the onset of diabetes-related complications.
The proposals for action target pregnant women, schoolchildren, advertising and the food and catering industry.
For existing pre-diabetics and diabetics, it recommends an intensive lifestyle management process and self-management training.
Referral to psychologists and social workers and accessible referral pathways for other healthcare professionals caring for people with diabetes had to be established.
Core psychosocial services for people with diabetes as part of the multidisciplinary team had to be established and resourced “as a matter of priority”, the document says.
The document advocates an ICT-based national register of people with diabetes that would allow for a recall system, where the service user was reminded to attend screening at the recommended time intervals.
Research shows that over a 12-month period, only 71 per cent of referred diabetics received eye screening, 59 per cent had a podiatry appointment and just 14 per cent had their urine tested for microalbuminuria (an early sign of diabetic kidney disease).
Setting up a 24/7 diabetes helpline for people on insulin is also being proposed.
The document can be viewed on www.msdc.gov.mt and the public can give recommendations by e-mailing consultations.meh-health@gov.mt by May 16.