With reference to the article ‘We don’t know number of people with diabetes’ (October 20), the National Diabetes Programme (NDP), of which I was the local project manager, was set up in collaboration with WHO in the late 1970s and early 1980s.

Its initial phases consisted of extensive, detailed population-based epidemiological studies on the prevalence, incidence, complications and co-morbidities (obesity, high blood pressure, life style habits, etc.) of diabetes.

The results and related research done in the light of these studies have been published in international medical journals and presented at international medical conferences.

The NDP then set in motion activities aimed at improving the delivery of diabetes health care. These ranged from upgrading the diabetes clinic at St Luke’s Hospital to the setting up of a diabetes register. Educational sessions were also organised and the Maltese Diabetes Association, founded by me and Mr Tancred Zammit, resulted of great benefit too.

Also envisaged were related record-keeping systems and strategies for the prevention and early detection of diabetes. In the late 1980s, however, there was a change in the set-up of the local diabetes services and unfortunately the further stages of this NDP were not adequately followed up.

The proposed new research project has valid aims. Yet I have some reservations on the cost-effectiveness of repeat population-based epidemiological studies as I doubt the extent of significant new knowledge that would induce important changes in the prevention and management of diabetes.

A national plan could and should be revived without necessarily waiting for the outcome of new studies particularly since the load of diabetes and its complications is basically known and later ‘estimates’ by WHO, based on past studies, are considered for most practical purposes to be reliable enough.

Furthermore, the importance of genetics, lifestyle modifications and education have been noted for a long time, while the main characteristics of high risk subjects are also well defined. Most of the needed preventive strategies and diabetes control policies could presumably still be validly formulated and well tackled from available data.

Further costly research should be concentrated on less well documented topics and on those shortcomings that cannot be adequately addressed at present.