The diabetes inpatient satisfaction (DIPSat) study demonstrated hyperglycaemia and hypoglycaemia episodes were often linked to timing of insulin and meals. Self-administration of insulin and time spent with a diabetes specialist nurse was associated with higher treatment satisfaction (Rutter et al 2013). Up to 40% of people with diabetes who wanted to were unable to monitor and manage their insulin while in hospital (NHS 2011).
People with diabetes using multiple daily injections or insulin pump therapy, who can demonstrate their competence at self-management, can be treated in the hospital under defined conditions with continuation of their usual programme of self-management. This is utilising the skills of advanced carbohydrate counting to permit the matching of mealtime insulin bolus doses to carbohydrate intake, and the use of a rule for the establishment of correctional doses for treatment of hyperglycaemia (Braithwaite et al, 2007).
