Development of a care plan/assessment tool
Q We are trying to develop a care plan/assessment tool for ward staff to use when people with diabetes are admitted to hospital to link in with our launch of “ThinkGlucose”. Does anyone have something which is being successfully used?
Linda Clapham, DSN, Wharfedale General Hospital, Otley
Localised insulin reactions
Q I have recently encountered a person who has developed a localised reaction to insulin therapy. We initially changed needles, thinking that this may have been the issue, but to no effect. Having changed insulin on several occasions we are still unable to resolve this problem. The person has type 2 diabetes, and because of other medical problems would not be a candidate for oral antidiabetes therapies. As you can imagine, this is not pleasant for the individual, and I wondered if any other DSNs had encountered this type of problem? I would welcome any suggestions that you can make.
Mary Trimble, Diabetes Nurse Educator, Aintree University Hospitals, Liverpool
A We have had several patients with this problem. Apparently the most common cause is a reaction to either the insulin protein itself or the preservative used, and since most insulins use the same preservative, changing the insulin usually does not help. We initially try antihistamines; if this is ineffective we have previously used a hydrocortisone injection at the same time as the insulin, and in one individual where neither of these treatments were effective, insulin pump therapy was initiated. These reactions can delay absorption of the insulin leading to increased risk of hypoglycaemia at unusual times.
Pat Miles, DSN, Diabetes Centre, Poole Hospital
Helping homeless adults to overcome the challenges of managing their condition.
16 Apr 2024