Patient selection: insulin-dependent diabetic
Requirements for the diabetic to be engaged in self-management while in the hospital:
(1) competent
(2) normal and stable level of consciousness
(3) clinically stable with a predictable daily insulin requirement
(4) successful self-management prior to admission
(5) physically able to measure blood glucose
(6) physically able to self-inject insulin
(7) capable of determining carbohydrate intake and adjusting insulin dose
(8) adequate oral intake
(9) keeps a complete record of blood glucose levels and insulin doses
The physician and nursing staff need to monitor the management and intervene as needed. A patient may be able to perform some of the requirements if unable to do all.
This can be an educational opportunity. Any problems in self-management can be observed and corrected.
If the patient has an insulin pump then the nurses may not be familiar with its operation. If the patient is unable to use the pump then insulin injections may be needed until the patient can participate.
