Royal Cornwall Hospitals have the following guidelines for referral to the inpatient specialist nurse team.
Diabetic ketoacidosis (DKA)/hyperosmolar hyperglycaemic state (HHS).
Patients who are receiving IV Sliding Scale Infusion.
New type 1 diabetes mellitus.
Patients requiring emergency Insulin start.
Profound/prolonged hypoglycaemia or patients admitted with primary cause of admission as hypoglycaemia.
Acute diabetes foot problems.
Routine referral
New/existing type 2 diabetes mellitus commencing insulin/sulphonylurea.
Enteral/ parental feeding regimens.
Recurrent hypoglycaemia.
Advice pre procedures ie, bowel prep, day case surgery.
Declining glycaemic control (blood glucose level <4 mmol/l or >12 mmol/l) where primary intervention and medical review has been unsuccessful.
Consider referral
Newly diagnosed type 2 diabetes on diet or starting Metformin.
Multiple complications of diabetes.
Education/equipment advice.
Patients undergoing bariatric surgery.
The full guidelines can be found here: www.rcht.nhs.uk/DocumentsLibrary/RoyalCornwallHospitalsTrust/Clinical/EndocrineAndDiabetes/DiabetesInPatientSpecialistNurseReferralCriertiaDISN.pdf
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