Quality Standards for Diabetes Care Toolkit


Guidelines for referral to inpatient specialist diabetes teams



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Guidelines for referral to inpatient specialist diabetes teams


Royal Cornwall Hospitals have the following guidelines for referral to the inpatient specialist nurse team.

Priority referral

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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