Self-administering and managing your insulin while you are in hospital

What is this information about?

This information is about giving yourself (self-administering) and managing insulin to keep your diabetes under control when you are staying in hospital.  

It tells you how and why staff will need to assess you to make sure that you are safe to do this. It also tells you the safest way to look after your insulin and needles in hospital.  

Why have I been given this information?

You have been given this information because you have diabetes and you are staying in hospital.  

It is likely that you are very knowledgeable about your condition. You will know how much insulin you need and when you need it.  

In hospital your medication and injections will usually be given to you by a nurse. But you may want to remain independent by: 

• choosing an appropriate insulin dose depending on how many carbohydrates you have eaten (self-managing your insulin)  
• giving yourself your insulin injections (self-administering your insulin). 

Whenever possible, and when it is safe for you, we will help you to do this.

Is self-managing insulin in hospital a good idea?

Self-managing your insulin can help to make sure that the doses are taken at the right time, and your blood glucose (blood sugar) levels are kept stable.  

If you are new to insulin, practising in hospital with support will help you to learn the skills you need cope with it when you go home. 

But we need to make sure that you can self-administer and manage your insulin safely because an incorrect dose of insulin can be dangerous.

How will staff make sure that I am safe to self-manage my insulin?

Hospital staff (doctors, nurses and pharmacists) will assess you to see whether it is safe for you to self-manage insulin in hospital.  

Examples when it may not be safe for you to do so is: 

• when you are very unwell 
• when you are waiting for an operation 
• if other changes have been made to your treatment that will affect your glucose (blood sugar) levels, like being started on steroid treatment. 

The hospital staff will also need to check that you understand: 

• what insulin you take   
• how you take your insulin (via insulin pen devices, vials and syringes or insulin pump) 
• the doses you need   
• how to do your injections 

If they decide that it is safe for you to self-manage your insulin, they will ask you to sign a consent form to confirm that you are happy to do so. If you have any questions, please ask the nurse before you sign. 

What will happen if it is not safe for me to self– administer or manage insulin?

If it is not safe for you to self-administer or manage your insulin, a nurse will give you your doses instead.  

If your condition changes in hospital, the nurse will re-assess you to see whether it is still safe for you to self-administer or manage insulin.

Do I have to self-administer insulin?

No. If you would prefer, the nurse can give you your insulin. They can re-assess you at another time if you change your mind. 

Can I monitor my own blood glucose level?

Yes. We will also monitor your blood glucose using the ward capillary blood glucose meters. These are very accurate.  

Tell your nurse if the blood glucose reading on your meter is less than 4mmol or higher than 14mmol while using an insulin pen or greater than 11mmol/l using an insulin pump. They will check the result on the ward meter. 

If your blood glucose levels are high and/or you are unwell your ketones will be checked to make sure you are not developing complications such as Diabetic Ketoacidosis (DKA).

What is the safest way to manage my diabetes in hospital?

For your safety and the safety of the other patients, you must: 

• Store your insulin out of sight in your Patient’s Own Medicine Locker 
• Dispose of any used needles immediately after use in the sharps container provided. Do not leave needles attached to your pen.  
• Record the dose of insulin and the time you took it on the insulin chart provided to you. Please ask a member of staff in you need a new insulin chart. 
• Record blood glucose readings you measure yourself on a separate chart provided. 
• If you are on an insulin pump you will need to have your own supply as hospital cannot provide this 
• Make sure that you have enough insulin and needles and tell your nurse if you are running low.  
• When you return home, store any spare insulin pens back in your fridge. The one you are using can be kept out of the fridge for up to one month. 

What happens if my insulin dose changes while I am in hospital?

If any changes are made to your medication while you are in hospital these will be explained in full before you are discharged (go home).  

If you have any questions about your insulin dose while you are in hospital, please speak to your nurse. If they cannot help you, they will direct you to someone who can. 

Who can I contact with my concerns or questions?

Please raise any concerns or questions to a nurse or doctor looking after you. We can offer the right support. We can also give you a specialist diabetes review by a nurse or doctor when needed.