Malta has some of the worst diabetes problems in Europe.

A relatively large number of Maltese are living with undiagnosed diabetes a pilot study has established, and the island’s first diabetes strategy is planning to address this.

Expected to be unveiled for consultation on Friday, the strategy has to be ambitious in its targets to reverse the present situation – Malta has some of the worst diabetes problems in Europe, ranking 26 from 30 countries in the European Diabetes Index 2014.

“There are significant lacunae in diabetic care, which have been left unattended for too long. We are determined to address these shortcomings in the best way possible,” Health Parliamentary Secretary Chris Fearne conceded.

But he is optimistic the strategy will propose a “concrete way forward”, with the more integrated involvement of family doctors, early detection of complications and the protocol-regulated introduction of new medicines.

A steering committee has been working on this strategy since May trying to create the relevant mechanisms for diabetics, which are estimated to make up 10 per cent of the population; and the numbers continue to rise.

Neville Calleja, committee head and the director for health information and research, said what was lacking was the consistent standard of care to prevent complications, as well as the need for an updated treatment entitlement plan.

Strategy puts pressure on the political class to map out the deliverables

Among the things lacking was the availability of specific drugs – such as the enzyme-inhibiting Sitagliptin – that has fewer side effects in the control of blood glucose.

This class of drugs has been around since 2007 but Malta and Poland remain the only two countries where patients are not reimbursed for Sitagliptin and it is not available on the government’s free drug formulary.

Dr Calleja said the situation would be changing and the healthcare benefits board was working on drawing up the best treatment plan. “The budget is being worked upon to include the introduction of gliptins as a class of drugs, and other necessary treatment by 2015,” he said.

Dr Calleja added: “The strategy puts pressure on the political class to map out the deliverables rather than leave it to the whim of pressure groups.”

During the consultation process stakeholders raised a number of issues, from the availability of glucose strips, to the need for specialised diabetes staff.

The most critical issues identified include: obesity and its links to type 2 diabetes; the need for early diagnosis; lifestyle modification; the role of dieticians, psychologists, prosthetists; the creation of a national diabetes register; and the importance for lifelong patient and family education and support.

The strategy proposes opportunistic screening in those over 45 and in persons over 18 who are at increased risk of developing diabetes. A systematic screening programme for eye and foot complications at a national level is also being recommended to allow early and aggressive treatment.