Uncontrolled diabetes should be recognised and appropriate management and follow-up arranged by a specialist diabetes team. In the majority of cases, people with uncontrolled diabetes should be managed in hospital by specialist care.
Diabetic ketoacidosis or hyperosmolar hyperglycaemic nonketotic syndrome is a recognised common medical emergency and must be treated appropriately. Review by the specialist diabetes team should occur within 24 hours of admission. Health economics must address this in the context of provision of expert medical and nursing input within secondary care.
The New Zealand Society for the Study of Diabetes (NZSSD) identifies the following points in their consensus statement on their Inpatient Consensus Statement (2013):
Every person with diabetes who is hospitalised has the right to:
receive optimum diabetes care based on ‘best practice’
have a hospital stay free from harm (especially insulin, medication and food errors) and not inappropriately prolonged as a result of their diabetes management
have access to specialist diabetes advice/care
where practically possible, be actively involved in their own diabetes management during their hospital stay
diabetes care following discharge from hospital that is timely, appropriate and well-informed (www.nzssd.org.nz/documents/misc/13%2007%20NZSSD%20Inpatient%20Consensus%20Statement%20-%20Final%20version.pdf).
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