English: Further, a range of common childhood illnesses such as flu, water infections or chest infections can be misleading and can sometimes lead to misdiagnosis, which is why it is so very important that we raise critical awareness of the potential meaning of these symptoms. I want to make it clear that this campaign, this debate, is not calling for population-wide screening. The Cabinet Secretary has made it clear that this would create concern about a significant number of unnecessary referrals and investigations. Therefore, this call is for screening to take place in every instance that a child or young person presents with the four symptoms that we know are key indicators of type 1 diabetes, the four Ts: tired, thirsty, toilet and having lost weight, being thinner - feeling more tired than usual, being thirsty and not being able to quench that thirst, going to the toilet a lot, bed-wetting by a previously dry child, or heavier nappies in babies, losing weight and looking thin and gaunt, more so than usual. If a GP believes a child to have type 1 diabetes, then they must refer them immediately and on the same day to their local specialist paediatric team to get immediate treatment and to prevent potentially fatal DKA. We know that testing for diabetes when these symptoms present is very easy, and it is very cost-effective when one considers that we are talking about a child's life. It takes two seconds. A finger-prick test undertaken by a GP every time a child presents with these symptoms allows for the detection of type 1 to take place as early as possible in primary care settings and thereby offers a real potential and a real chance to reduce the instances of undiagnosed type 1 diabetes. This has been supported in evidence received by the Petitions Committee from Diabetes UK, the children and young people's Wales diabetes network, through representation from Dr Christopher Bidder, whose letter is supported by a number of health boards, as well as the Royal College of Paediatrics and Child Health. The Royal College of Nursing has noted that the four Ts should be asked routinely as part of a history-taking exercise. In principle, there would be no reason why blood glucose testing of children and young people shouldn't be carried out more routinely in primary care settings. Devices are portable, they're inexpensive, and this provides flexibility about where the tests can be carried out. But staff do have to be adequately trained and the resources available to carry out the test - and, obviously, the required follow-ups. Additionally, Betsi Cadwaladr University Local Health Board has noted that education for primary care health professionals should include raising the awareness of the classic symptoms for type 1 diabetes and prompt on-the-spot finger-prick blood glucose testing for any individual. Clearly, there is much support for this proposal. So, why is it not being taken forward effectively, and why is this concern not being taken seriously? Despite almost worldwide support for a finger-prick test when children present with these symptoms, and the presence of finger-prick equipment in all GP surgeries, the Royal College of Nursing has noted that currently there are no agreed national standards for primary care education relating to diabetes. In taking evidence in committee, we soon became aware that there do still remain some disparities across health boards in terms of type 1 diabetes pathways for children and young people. In their written submissions, only the Cardiff and Vale, Cwm Taf and the Betsi board specifically mention the pathway by name. Abertawe did not specifically mention a pathway, but noted that GPs were expected to follow National Institute for Health and Care Excellence guidelines. Aneurin Bevan stated that they do not have a formal pathway, but noted their expectations for referral to a children's unit for same-day assessment were in line with NICE guidance. Powys noted a limited variation in their diagnosis and referral pathway due to the various NHS providers used in different areas of the health board, and stated that it does not have a policy for point-of-care blood glucose testing in primary care. Hywel Dda did not specifically detail a pathway or even refer to the NICE guidance. There is some progress: Cardiff and Vale noted that an all-Wales pathway for diagnosis of diabetes in children and young people is in the final stages of preparation. The pathway emphasises point-of-care blood glucose testing in all children where diabetes might be suspected, in accordance with NICE guidelines, yet no mention of the four Ts is made here and this is the critical point here. We still await the outcome of the all-Wales pathway. Now, I trust that following this debate and, more so, following the massive campaign that this family, Diabetes UK and other organisations, medical - you know, people in the medical sector. They've really emphasised the need that, when children present with the four Ts, a simple glucose blood prick testing would really made the difference. I suppose, really, the reason I'm raising this here today is the frustration that the Cabinet Secretary will not push forward with a drive to ensure that this simple testing can take place in all GP surgeries when children with the four Ts present. I'd like to finish by quoting Beth Baldwin once more on our aims here, which are immediate, short and long term: 'Sharing Peter's story and introducing type 1 testing as part of protocol, refreshing GP and primary care awareness, annual e-learning for the dangers of undetected type 1 diabetes, working in partnership with organisations to create awareness campaigns.' Cabinet Secretary, I urge you to consider this as a matter of vital priority. The cost for such a campaign for routine screening is low and, again, does not compare when we're talking of the life of just one child. It is crucial that we work to prevent the risk of potentially fatal DKA for the 24 per cent of children and young people who are diagnosed late and at a critical, life-threatening stage, with type 1 diabetes. Clearly, here, vigilance and testing can save lives. You have the power and you have the ability to get that message across. Please do it, Cabinet Secretary. Thank you.
Welsh: Ymhellach, gall amryw o afiechydon plentyndod cyffredin megis ffliw, heintiau dŵr neu heintiau ar y frest arwain at ddiagnosis anghywir weithiau, a dyna pam y mae'n bwysig iawn ein bod yn codi ymwybyddiaeth feirniadol o ystyr posibl y symptomau hyn. Rwyf am ei gwneud yn glir nad yw'r ymgyrch hon, y ddadl hon, yn galw am sgrinio'r boblogaeth gyfan. Mae Ysgrifennydd y Cabinet wedi dweud yn glir y byddai hyn yn creu pryder ynghylch nifer sylweddol o atgyfeiriadau ac archwiliadau diangen. Felly, galwad yw hon am sgrinio ym mhob achos pan fo'r plentyn neu'r person ifanc yn dangos y pedwar symptom y gwyddom eu bod yn ddangosyddion allweddol o ddiabetes math 1: teimlo'n fwy blinedig nag arfer, bod yn sychedig a methu torri'r syched hwnnw, mynd i'r toiled yn aml, gwlychu'r gwely gan blentyn sydd wedi bod yn sych cyn hynny, neu glytiau trymach mewn babanod, colli pwysau ac edrych yn denau ac yn ddi-raen, yn fwy felly nag arfer. Os yw meddyg teulu'n credu bod diabetes math 1 ar blentyn, mae'n rhaid iddynt eu hatgyfeirio ar unwaith ac ar yr un diwrnod at eu tîm pediatrig arbenigol lleol i gael triniaeth ar unwaith ac i atal DKA a allai fod yn angheuol. Rydym yn gwybod bod cynnal profion am ddiabetes pan fydd y symptomau hyn yn bresennol yn hawdd iawn, ac mae'n gosteffeithiol iawn pan ystyriwch ein bod yn sôn am fywyd plentyn. Mae'n cymryd dwy eiliad. Mae prawf pricio bys gan feddyg teulu bob tro y bydd plentyn yn dangos y symptomau hyn yn ei gwneud hi'n bosibl darganfod math 1 mor gynnar â phosibl mewn lleoliadau gofal sylfaenol ac felly'n cynnig y posibilrwydd a'r gobaith gwirioneddol y gellir cyfyngu ar yr achosion o ddiabetes math 1 lle na wnaed diagnosis. Ategwyd hyn mewn tystiolaeth a gafodd y Pwyllgor Deisebau gan Diabetes UK, rhwydwaith diabetes plant a phobl ifanc Cymru, drwy sylwadau gan Dr Christopher Bidder, y cefnogwyd ei lythyr gan nifer o fyrddau iechyd, yn ogystal â Choleg Brenhinol Pediatreg ac Iechyd Plant. Mae'r Coleg Nyrsio Brenhinol wedi nodi y dylid gofyn ynglŷn â'r pedwar symptom fel mater o drefn yn rhan o ymarfer nodi hanes blaenorol. Mewn egwyddor, ni ddylai fod unrhyw reswm pam na wneir profion glwcos gwaed ar blant a phobl ifanc yn fwy rheolaidd mewn lleoliadau gofal sylfaenol. Mae'r dyfeisiau'n gludadwy, nid ydynt yn ddrud, ac mae hyn yn cynnig hyblygrwydd o ran lle y gellir cynnal y profion. Ond mae'n rhaid i staff fod wedi'u hyfforddi'n ddigonol a rhaid i'r adnoddau fod ar gael ar gyfer cynnal y prawf - a'r driniaeth ddilynol sy'n ofynnol, wrth gwrs. Yn ogystal, mae Bwrdd Iechyd Lleol Prifysgol Betsi Cadwaladr wedi nodi y dylai addysg i weithwyr iechyd proffesiynol gofal sylfaenol gynnwys codi ymwybyddiaeth o symptomau nodweddiadol diabetes math 1 a phrawf pricio bys glwcos gwaed yn brydlon yn y fan a'r lle i unrhyw unigolyn. Yn amlwg, mae llawer o gefnogaeth i'r cynnig hwn. Felly, pam nad yw'n cael ei hyrwyddo'n effeithiol, a pham nad yw'r pryder hwn yn cael y sylw difrifol y mae'n ei haeddu? Er gwaethaf cefnogaeth bron yn fyd-eang i brawf pricio bys pan fydd plant yn dangos y symptomau hyn, a phresenoldeb cyfarpar y prawf pricio bys ym mhob meddygfa, mae'r Coleg Nyrsio Brenhinol wedi nodi nad oes safonau gofynnol cenedlaethol wedi'u cytuno ar hyn o bryd ar gyfer addysg gofal sylfaenol ynglŷn â diabetes. Wrth gymryd tystiolaeth yn y pwyllgor, daethom yn ymwybodol fod gwahaniaethau'n parhau rhwng y byrddau iechyd o ran llwybrau diabetes math 1 ar gyfer plant a phobl ifanc. Yn eu cyflwyniadau ysgrifenedig, byrddau Caerdydd a'r Fro, Cwm Taf a Betsi Cadwaladr yn unig sy'n cyfeirio at y llwybr yn benodol, ond roeddent yn nodi bod disgwyl i feddygon teulu ddilyn canllawiau'r Sefydliad Cenedlaethol dros Ragoriaeth mewn Iechyd a Gofal. Nododd Aneurin Bevan nad oes ganddynt lwybr ffurfiol, ond roeddent yn nodi eu disgwyliadau ar gyfer atgyfeirio at uned i blant am asesiad ar yr un diwrnod yn unol â chanllawiau NICE. Nododd Powys amrywiad bach yn eu llwybr diagnosis ac atgyfeirio oherwydd y gwahanol ddarparwyr GIG a ddefnyddir yng ngwahanol ardaloedd y bwrdd iechyd, a dywedodd nad oes polisi ganddo ar gyfer cynnal profion glwcos gwaed yn y pwynt gofal mewn gofal sylfaenol. Ni fanylodd Hywel Dda ar unrhyw lwybr penodol na chyfeirio at y canllawiau NICE hyd yn oed. Gwelir rhywfaint o gynnydd: nododd Caerdydd a'r Fro fod llwybr Cymru gyfan ar gyfer gwneud diagnosis o ddiabetes mewn plant a phobl ifanc wrthi'n cael ei gwblhau. Mae'r llwybr yn pwysleisio'r angen i gynnal profion glwcos gwaed yn y pwynt gofal i bob plentyn lle yr amheuir bod diabetes yn bresennol, yn unol â chanllawiau NICE, ac eto ni cheir unrhyw sôn am y pedwar symptom a dyma'r pwynt critigol yma. Rydym yn dal i ddisgwyl am ganlyniad y llwybr Cymru gyfan. Nawr, yn dilyn y ddadl hon, ac yn fwy felly, yn dilyn yr ymgyrch enfawr y mae'r teulu hwn, Diabetes UK a sefydliadau eraill, pobl feddygol - wyddoch chi, pobl yn y sector meddygol. Maent wedi pwysleisio'r angen, pan fydd plant yn dangos y pedwar symptom, yr angen i gynnal profion gwaed glwcos syml drwy bricio bys, rhywbeth a fyddai'n gwneud gwahaniaeth go iawn. Mae'n debyg, mewn gwirionedd, mai'r rheswm rwy'n codi hyn yma heddiw yw'r rhwystredigaeth na fydd Ysgrifennydd y Cabinet yn mynd ati i hyrwyddo ymgyrch er mwyn sicrhau bod y profion syml hyn yn gallu digwydd ym mhob meddygfa pan fydd plant yn dangos arwyddion o'r pedwar symptom. Hoffwn orffen drwy ddyfynnu Beth Baldwin unwaith yn rhagor ar ein hamcanion yma, sy'n cynnwys rhai uniongyrchol, byrdymor a hirdymor: Rhannu stori Peter a chyflwyno profion math 1 fel rhan o brotocol, adnewyddu ymwybyddiaeth meddygon teulu a gofal sylfaenol, e-ddysgu blynyddol am beryglon diabetes math 1 heb ei ganfod, gweithio mewn partneriaeth â sefydliadau i greu ymgyrchoedd codi ymwybyddiaeth. Ysgrifennydd y Cabinet, rwy'n eich annog i ystyried hyn fel blaenoriaeth hollbwysig. Mae'r gost am ymgyrch o'r fath ar gyfer sgrinio rheolaidd yn isel ac unwaith eto, nid yw'n cymharu pan fyddwn yn sôn am golli bywyd un plentyn hyd yn oed. Mae'n hanfodol ein bod yn gweithio i atal risg DKA a allai fod yn angheuol i 24 y cant o blant a phobl ifanc sy'n cael diagnosis hwyr ac ar gam critigol sy'n bygwth bywyd, o ddiabetes math 1. Yn amlwg, yn hyn o beth gall bod yn wyliadwrus a phrofion achub bywydau. Mae gennych bŵer a gallu i gyfleu'r neges honno. Os gwelwch yn dda, gwnewch hynny, Ysgrifennydd y Cabinet. Diolch.