Severe hypoglycaemia is a recognised common medical emergency, and must be treated appropriately. In the majority of cases, people with type 1 diabetes should be under specialist care.
The District Health Board (DHB) should:
have a ‘clinical lead’ for the management of diabetes
have the services of a dedicated Diabetes Inpatient Specialist Nurse (DISN) at staffing levels most recently recommended by Diabetes UK (1.0 FTE per 300 beds) (NICE 2011)
collect data about the outcomes for patients admitted with severe hypoglycaemia
have a Quality Assurance Scheme in place to ensure accuracy of blood glucose meters
have a training programme in place for all health care staff expected to prescribe, prepare and administer insulin (eg, the safe use of insulin and the safe use of intravenous insulin e learning packages from National Health Service [NHS] Improving Quality)
ensure they commission a service providing access to a specialist diabetes team prior to a patient’s discharge with follow-up after discharge for all patients presenting to the Emergency Department or admitted to hospital with severe hypoglycaemia.
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