Recently an NHS diabetes specialist nurse tweeted her advice to health care professionals looking after inpatients with diabetes who are on insulin.
Is it just me or does anybody else find the nursery rhymes approach to administering lethal drugs just an incy-wincy, teeny weeny bit worrying?
Diabetes of any type is not a simple condition to treat, one wonders what “simplicity is key” to, untimely death from hypo or hyperglycaemia whilst in hospital?
Blood sugar levels are not vague omens like tea leaves, oh it’s the grim (doubles) there may be something bad in the future-watch out for it. They are biochemical facts and require interpretation in a scientific fashion and acting upon, be that a decision to monitor in another few hours, an insulin dose, a glucose drip, hydration, carbohydrate ingestion-not just some vague idea of “watching out”.
There is ample evidence that care of inpatients with diabetes is woeful and in fairness the diabetes nurse* in question was making an attempt to improve the situation within the limits of her jurisdiction but that this sort of approach is suggested by anyone who works with diabetes patients should strike fear into the heart of everyone on insulin. Imagine if somebody suggested little ditties be used to calculate chemotherapy doses or for anaesthesia? Doesn’t sound right does it?
Surely anybody in need of such slogans should not be anywhere near an insulin pen and an ill patient?
Sadly the results of the UK Diabetes inpatient audit show that ‘professionals’ so woefully ignorant about diabetes do get near patients and do calculate and administer doses. Here is a blog I wrote in 2014 about this data and it seems nothing has improved since then. As I mention there, it’s extremely doubtful that the situation in Australia is any better than it is in England, at least England collects the data. The fact that so little is done about it is shameful though, might just as well not collect the data if you’re not going to do anything about it.
For what it’s worth, I believe people with diabetes, diabetes advocacy organisations, diabetes educators and endocrinologists should unite to cal for better treatment of inpatients. My suggestion is the employment of more diabetes nurse educators (as they’re called in Australia) and that each patient who is on insulin has a DNE assigned to their case.
*The tweet has subsequently been deleted.Tweet