Table 1.

Rationale for assigning an EAG to diabetes mapped to Kingdon’s streams

Stream	Quote
Problem stream
Cost	“Well diabetes is 15% of our total health-spend, a major epidemic coming at us, and if that can’t hit a policy agenda what can!” “…regardless of whether it was being driven by the HSE, health care professionals were lobbying and doing it anyway.” Hence, there was support within the political stream as people were advocating for change.
Cost and complications	“It permeates many other medical illnesses. It has a very big impact on cardiac disease and a very big impact on costs and complications of diabetes.”
Epidemic of growing importance	“We keep talking about this ticking time bomb but it’s just getting more and more of an issue. And as our population ages it’s becoming more of an issue.”
Lack of policy in the area	“It’s well known that in Ireland we have a very poorly organised diabetic care system so I think lots of people in senior positions both in the Dept. of Health and the HSE know that, so it was a glaring omission. We have a cardiovascular strategy and a cancer strategy…”
Policy stream
Existing groundwork	“…there were some things that were happening on the ground, I mean regardless of whether it was being driven by the HSE, health care professionals were lobbying and doing it anyway.”
Politics stream
Interested groups and individuals advocating for change	“I think as well there were a lot of soldiers’ voices in diabetes and a lot of influence in media at that time so that’s why it was seen as the one most in shape or most ripe for movement on.”