We aim to enable you to manage your own diabetes whilst in hospital wherever possible as we appreciate that it is a source of frustration and anxiety when control is taken away from you with regards to your diabetes management. As you may expect, however, there are times when control will need to be taken over by hospital staff i.e if you are having surgery. If you are having an operation or procedure, or are coming into hospital for tests, you may need to starve and/or omit diabetes medications/insulin. You may also need to have an intravenous infusion of insulin prior to and following your procedure. This will mean that the nurses will need to check your blood sugars frequently but this will be discontinued as soon as you are eating and drinking.
You may also find that your blood sugars are monitored more frequently than you would normally do at home, particularly if you have suffered hypoglycaemia or are having high blood sugar readings. You can be assured, however, that you will be encouraged and supported to become self-caring again as soon as possible.
If you normally take insulin for your diabetes we will, wherever possible, support you to continue administering this yourself as we recognise that self management is the cornerstone of diabetes care. We appreciate the benefits of self-administration in that your insulin will be given at the appropriate time in relation to meals, and patients will be able to make appropriate dose adjustments based on dietary intake and blood glucose measurements.
Our self-administration of insulin scheme involves recording your own blood glucose levels throughout the day and administering the appropriate doses of insulin when needed as you would normally do at home. You must always record and inform nursing/medical staff of any blood glucose readings less than 4mmols/L and any treatment you have taken to treat the low reading.
You must also agree to report to nursing/medical staff any readings above 12mmols/L and to record insulin doses administered and time given. Nursing staff will explain to you where you will need to record all this information.
On admission to the hospital, or as soon as possible thereafter, an initial assessment will be carried out by nursing staff to ensure that self-administration is suitable for your needs. Although strongly encouraged, it is not compulsory and you may decline or ask to be withdrawn from the self-administration scheme at any time. You will be given all the necessary information and support you require to monitor your blood glucose levels and administer your own insulin during your hospital stay. We would ask you to bring in a supply of your regular insulin and your own blood glucose monitor and supplies needed in order for you to continue self-managing your diabetes. If you do not have supplies with you, and are unable to have them brought into hospital, we will be able to arrange for the necessary supplies to be provided. A sharps bin will also be provided for you to safely dispose of needles used for insulin administration and lancets.
The insulin you bring into hospital will need to be checked by nursing and pharmacy staff to ensure that it is suitable for use and they may need to ask you questions about where the insulin has been stored and how long it has been in use. The insulin you are using should be locked in your bedside locker. Any insulin not in use will need to be stored in the medicines fridge so please ask a member of nursing staff to place your insulin in the fridge if this has not been done following your initial assessment.
Nursing staff will need to reassess daily whether you remain able to self-administer insulin and may ask you how you are getting on and if you require any help or support. We hope that you do not find this insulting and are able to appreciate that we have to monitor ongoing suitability for self-administration for legal and professional reasons. If you feel that you need support from the specialist diabetes team at any time during your admission please feel free to ask staff to make a referral on your behalf. You may feel that your hospital admission is a good time to resolve any problems that you might have been experiencing with your diabetes management at home and the specialist team are here to help you.
Finally, please feel free to ask your nurse, pharmacist or the specialist diabetes team any questions about the self-administration of insulin scheme at any point during your hospital stay. Any feedback would also be appreciated about the scheme in order to enhance and improve the patient experience with regards to their diabetes care and management.