A new community-based initiative aimed at improving diabetes care in Ireland has revealed promising outcomes, according to a study published in the Irish Journal of Medical Science.

The study, which analyzes referral patterns and patient characteristics, highlights both the successes and challenges faced by the country's inaugural community hub diabetes service during its first year of operation.

Enhanced Community Care (ECC) for type 2 diabetes in Ireland introduces episodic, community-based, consultant-led multidisciplinary care of diabetes that in turn supports the general practitioner (GP)-delivered chronic disease management programme (CDMP). 

The Dublin North West (DNW) hub, Ireland’s first fully operational ECC hub, began providing its diabetes service in March 2023.

This study reviewed the first year of the DNW hub’s diabetes operations, focusing on referral patterns, patient demographics, clinical characteristics and CDMP eligibility (only those people living with type 2 diabetes with a medical card or a GP visit card are eligible for CDMP for type 2 diabetes.

Otherwise, people living with type 2 diabetes must self-pay for GP-provided type 2 diabetes care. 

A retrospective analysis was conducted on patient charts and hospital databases for all referrals to the DNW hub from March 2023 to March 2024.

Out of 204 referrals, 67% were redirected from hospital waiting lists, 22% were direct GP referrals, and 11% were internal from other hub services. The average wait time from referral to first appointment was 8.6 weeks.

Attendees were 44% female and 56% male, with an average age of 56.2 years. Notably, only 46% were eligible for CDMP. 

During the study period, the number of people living with T2DM waiting for diabetes appointments at Connolly Hospital decreased by 61%, with the average waiting time reduced from 11 to 5 months.

The first year of activity in the DNW hub illustrates the potential of the ECC model to positively impact hospital waiting lists. Our data also suggests that eligibility to access the CDMP may merit expansion as part of the ongoing implementation of ECC in Ireland.

The program, launched to reduce the burden on hospitals and provide more accessible care to individuals with diabetes, has seen a strong uptake across multiple regions. The initiative was designed to shift the management of diabetes to a community-based setting, offering patients easier access to specialised care, monitoring, and education. It also aims to promote early intervention, ultimately improving long-term health outcomes for diabetes patients.