PCDS newsletter: The 6th All-Ireland Conference of the PCDS

The 6th All-Ireland Conference of the Primary Care Diabetes Society took place in Athlone on 13 April 2013.

As part of the agenda, delegates were provided with an update from the National Diabetes Programme, presented by Dr Diarmuid Smith, the National Clinical Lead, and co-Lead Dr Velma Harkins. They reported substantial progress in the areas of:

• Retinopathy screening (a national screening programme has commenced).
• The diabetic foot (including a guideline and pathway of care for low-, medium- and high-risk feet).
• Revised national guidelines relating to the use of HbA_1c in the diagnosis of diabetes.
• A new initiative concerning pregnancies affected by diabetes.

The integrated care pathway for diabetes management in primary care was described in detail, although how and exactly when this will be implemented remains dependent on state finances. It is a sign of the current difficulties that the Government has decided to abandon its intention to provide free GP care for everyone with diabetes, and there are no current negotiations towards remuneration of general practice for diabetes care.

Other topics covered included renal disease, weight management and its impact on glucose control, and an individual approach to prescribing for glucose control in type 2 diabetes.

Workshops included a primary care perspective on diabetes in pregnancy, access to care for vulnerable groups such as the travelling community, a practical approach to the national foot care programme, and discussion of some difficult cases.

The overall theme running through the meeting was that targeting the underlying problems, particularly the reversible elements of obesity and insulin resistance, is an effort that deserves our attention, and the increasing range of glucose-lowering options increasingly enables us to target these problems.