GP Services
Chronic Disease Management

Diabetes Mellitus Type 2 is a metabolic disease, involving inappropriately elevated blood glucose levels and resistance to insulin. It is estimated that 4.8% (161,500) of the Irish population have type two diabetes. People with diabetes run a greater risk of developing one or more severe health complications such as heart disease, stroke, chronic kidney disease, nerve damage, and other problems with feet, oral health, vision, hearing, and mental health.

Chronic Disease Management (CDM) is individualised, but in the main consists of strategies which lower blood sugar levels via lifestyle and medication, other risk factor modification, regular review and screening programmes - all of which reduces the likelihood of serious complications.

Asthma is a condition in which your airways narrow and swell and may produce extra mucus. Asthma in Ireland affects 7% in Irish adults and 21% in Irish children which amounts to about 460,000 people in Ireland. Symptoms include shortness of breath, chest tightness or pain, wheezing when exhaling, trouble sleeping caused by shortness of breath/coughing/wheezing, coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu, amongst other symptoms.

Triggers for asthma include sinus infections, allergies, particles in the air, pollen, breathing in some chemicals, acid reflux, physical exercise, cold dry air amongst others. Chronic Disease Management (CDM) is individualised, but in the main for asthma it consists of strategies which aim to reduce the risk of complications via lifestyle, preventative medicine, with inhalers, vaccination programmes and minimisation of related risks.

Chronic ischaemic heart disease relates to poor blood flow to the heart which deprives it of oxygen. The coronary arteries supply blood to the heart. Hardening, or narrowing of these arteries is known as coronary artery disease. This can lead to shortness of breath, fatigue, angina (chest pain) and also heart attacks. Cardiovascular disease is associated with 9,000 mortalities a year in Ireland. Chronic Disease Management (CDM) is individualised, but in the main relates to risk factor minimisation for chronic ischaemic heart disease with management of the following and similar; high blood pressure, diabetes, physical activity, lipids (cholesterol) levels and smoking.

Atrial fibrillation, sometimes called "a fib", is a heart condition that causes an irregular and often abnormally fast heart rate. It can be associated with palpitations, dizziness, shortness of breath and tiredness. In atrial fibrillation, the heart's upper chambers (atria) contract randomly and sometimes so fast that the heart muscle cannot relax properly between contractions. This reduces the heart's efficiency and performance.

Atrial fibrillation is the most common heart rhythm disturbance. Irish research has shown that 3.2% of the total population aged over 50, 5.3% in the over 65’s and almost 11% in those aged over 80 years old have atrial fibrillation. It is more likely to happen in people with high blood pressure, ischaemic heart disease, and heart valve issues. Having atrial fibrillation is also a risk factor for stroke. Chronic Disease Management (CDM) is individualised, but in the main for atrial fibrillation relates to detection, heart rate control and anticoagulation, as well as other options including interventions with cardiology.

Chronic obstructive pulmonary disease (COPD) is a disease of the airways whereby they become inflamed, damaged and narrowed. The main cause, at over 70%, is smoking or passive smoking (breathing in other people's tobacco smoke). Approximately 20% of smokers will develop the disease. Symptoms include shortness of breath, a persistent chesty cough with phlegm that does not go away, frequent chest infections, persistent wheezing amongst others. In Ireland it is estimated that 500,000 (10% of population) people are living with COPD yet only 200,000 (4% of population) are diagnosed.

Complications of COPD include respiratory infections, severe limitations in physical activities, heart problems, lung cancer, high blood pressure in lung arteries and a dependence on oxygen to breathe. Chronic Disease Management (CDM) is individualised, but in the main for COPD it consists of strategies which aim to reduce the risk of complications via lifestyle, preventative medicine, with inhalers, vaccination programmes and minimisation of related risks.

Heart failure means that the heart is unable to pump blood around the body properly. It usually happens because the heart has become too weak or stiff. Symptoms of heart failure include shortness of breath, fatigue, weakness, chronic cough, swelling in the legs/ankles/feet, sleeping on several pillows, amongst other symptoms.

Current Irish data suggest a 2% of the Irish population (rising to 10% in those > 75 years) is symptomatic with heart failure, with a further 2% having no symptoms but at risk of progressing to symptomatic failure with over 10,000 new cases are diagnosed annually. Heart failure is a leading cause of hospitalisations in Ireland.

Chronic Disease Management (CDM) is individualised, but in the main for heart failure it centres around managing the cause, minimising the risk of complication, and symptomatic relief.

A stroke occurs when there is a blockage to the blood supply to part of the brain or when a blood vessel in the brain bursts. In either case, parts of the brain become damaged or die. A stroke can cause lasting brain damage, long-term disability, and mortality. Approximately 10,000 Irish people have a stroke each year, and currently approximately 30,000 are living with disabilities following a stroke.

Chronic Disease Management (CDM) is individualised, but in the main relates to risk factor minimisation for stroke with management of the following and similar; high blood pressure, diabetes, abdominal circumference, smoking, lipids (cholesterol) levels, and abnormal heart rhythms.

A transient ischaemic attack (TIA), or mini stroke, happens when there is a temporary disruption in the blood supply to part of the brain. The disruption in blood supply results in a lack of oxygen to the brain. This can cause sudden symptoms like those of a stroke however without permanent disability. One-third of the people with TIA can later have recurrent TIAs and one-third can have a stroke because of permanent nerve cell loss. Having a TIA is a risk factor for eventually having a stroke.

Chronic Disease Management (CDM) is individualised, but in the main relates to risk factor minimisation for stroke with management of the following and similar; high blood pressure, diabetes, abdominal circumference, smoking, lipids (cholesterol) levels, and abnormal heart rhythms.