Caring for Diabetes patients who require hospital admission

Over a million people with diabetes were admitted to hospital in England in 2017. We know that 92% of them were not admitted because of their diabetes. A hospital stay for a person with diabetes can be a frightening experience and cause some anxiety. Inpatient care for diabetes costs the NHS £2.5 billion. That’s 11% of the entire budget spent on inpatient care.

The inpatient Diabetes team at Colchester General Hospital would like to reassure you and answer any concerns you may have within this article.

Having an inpatient diabetes team can reduce length of stay and improve patient care and experience. The team works for the North East Essex Diabetes Service (NEEDS) and are contracted by East Suffolk and North Essex NHS Foundation Trust (ESNEFT) to cover all inpatient diabetes care. Our team consists of: 3 Consultants, 2 dieticians, 1 mental health nurse, 5 administration staff, 2 midwifes, 2 podiatrists and 8 diabetes specialist nurses.

We work 7 days a week and also cover specialist clinics within the community. We provide education for both Type 1, Type 2 and gestational diabetes across North East Essex and we are link nurses for all the GP surgeries who require extra support. We also run a virtual ward clinic for patients who requires district nurse support for insulin administration and titration. Having the access to all of the above means that we are able to provide a seamless service for all our inpatient diabetes patients who require future care once discharged from hospital.

We ensure all staff across the hospital are educated and kept up to date about diabetes. We hold monthly diabetes link nurse meetings and offer university courses for further diabetes education. We are proud to have trained 6 pharmacists within diabetes and they are able to pick up any medication errors that may occur and ensure all medications are prescribed correctly and in a timely manner.

All patients admitted into hospital should be supported by the inpatient diabetes team. Nursing staff will refer all diabetes patients to our team within 24 hours. They will also check the patient’s feet for wounds, colour, pulses and sensation.  If there are any concerns with either diabetes management or with feet then they should be referred and reviewed by the diabetes team within 24 hours of admission.

Nursing staff will monitor blood glucose levels with the hospital blood glucose meter. Patients can use their own meters but nursing staff will need to also test with the hospital meter as the readings are stored on a data base for the diabetes team to review.

We encourage the patient to manage their diabetes care, if able to, as much as possible. You should bring in all your prescribed medication and any blood glucose diary or meter you use at home for recording your readings, so that the diabetes team can review them.

If you use an insulin pump to control your blood glucose levels and you are able to care for the pump by yourself during your hospital stay, then continue to do so. If you are unable to self-care for your pump due to sickness, the nursing staff will ask you to either remove or they will remove your pump for you. They might then commence an insulin infusion or revert back to insulin injections until you are well enough to manage your insulin pump. Nursing staff are not trained to support insulin pumps. A diabetes specialist nurse will review you during your hospital stay. Please ensure you bring all pump equipment with you as these are not supplied within the hospital.

If you take a long-acting insulin (Tresiba, Toujeo, Lantus, Levemir, Humulin I, Insulatard and Abasaglar) you should always continue to take this insulin even if put on an insulin infusion or Nil By Mouth.

Any concerns with regards to your diabetes please ask the nursing staff to make contact with our team.

Diabetes Practitioner, North East Essex Diabetes Service (NEEDS)
Emma Birbeck