Clinical Guideline Diabetes management during surgery (adults)
|
|
- Randolf Bennett
- 8 years ago
- Views:
Transcription
1 Clinical Guideline Diabetes management during surgery (adults) Standard 8 of the National Service Framework for Diabetes states that all children, young people and adults with diabetes admitted to hospital, for whatever reason, will receive effective care of their diabetes. Wherever possible they will continue to be involved in decisions concerning the management of their diabetes. National guidance entitled Day Surgery and the Diabetic patient states: the aim is to manage the diabetes according to safe and simple protocols. This guideline aims to enhance the care provided to patients with diabetes during surgery. It applies to all surgical patients with type 1 or type 2 diabetes who are controlled on oral anti-diabetic medication and/or insulin. It is split into those undergoing morning procedures and those undergoing afternoon procedures. The purpose of this guideline is to: Give practical advice to clinical staff on how to manage patients with diabetes who are undergoing surgery. Ensure that patients with diabetes maintain effective glycaemic control and minimise hypoglycaemic events during admission. Preoperative diabetic control Ideally all patients should have their diabetes well controlled and should have a glycosylated haemoglobin (HbA1c) level of less than 7.5 (this is measured during pre-op assessment). A HbA1c of between 7.5 and 9.0 suggests inadequate control of diabetes. A HbA1c above 9.0 indicates poor control of diabetes. The decision to operate or postpone a routine operation in a poorly controlled diabetic should be taken jointly by surgeons and anaesthetists taking into consideration other comorbidities and patient-specific factors and by assessing the risks / benefits involved. On the day of surgery a preoperative blood glucose level should be checked and documented. A level of 4 12 mmol/l is acceptable although, ideally, it should be between 6 10mmol/L. If the patient s blood sugar is above 12 mmol/l, the anaesthetist or the surgical team should be informed so that further management (eg, a glucose/potassium/insulin [GKI] infusion) can be considered (see page 5). Patients with diabetes should be operated first on the list (whether in the morning or afternoon) so that there is minimal disruption of their diet and medication. Page 1 of 5
2 Morning procedures 1. Patients on oral antidiabetic medicines (eg, metformin, gliclazide) and/or longacting insulin (eg Lantus, Levemir ) Oral antidiabetic medicines and long-acting insulins should be taken as normal Withhold oral antidiabetic medication. Continue long-acting insulin (if due on the morning of procedure). Oral antidiabetic medicines can be taken after the operation once the patient has had their first meal (ie, the morning dose should be taken after lunch). 2. Patients on twice-a-day insulin regimen: (eg: Novomix 30, Humalog Mix 25 ) Omit morning insulin dose Administer half the morning dose of insulin after the patient has eaten lunch (this is to avoid hypoglycaemia as the patient may not prefer to have a normal meal and to ensure that the patient does not vomit or refuse meal) If the procedure is delayed beyond midday, consider starting a GKI infusion (see page 6). Page 2 of 5
3 3. Patients on four-times-a-day insulin regime (ie: basal-bolus) Omit morning insulin dose of short-acting insulin (eg, Humalog, Novorapid, Apidra or Actrapid ). Continue the same dose of long-acting insulin (whether taken the night before or on the morning of the procedure) Administer half the morning dose of short-acting insulin after patient has eaten lunch (this is to avoid hypoglycaemia as the patient may not prefer to have a normal meal and to ensure that the patient does not vomit or refuse meal) If the procedure is delayed beyond midday, consider starting a GKI infusion (see page 6). Afternoon procedures 1. Patients on oral antidiabetic medicines (eg, metformin, gliclazide) and/or longacting insulin (eg Lantus, Levemir ) Oral antidiabetic medicines and long-acting insulins should be taken as normal Oral antidiabetic medicines should be taken as normal provided the patient eats a light breakfast (otherwise, the dose should be omitted) Continue long-acting insulin (if due on the morning of procedure). Lunchtime on the day of the procedure: Omit lunchtime dose of oral antidiabetic medicines Oral antidiabetic medicines can be taken after the operation once the patient has had their first meal (ie, the evening dose should be taken after an evening meal). Page 3 of 5
4 2. Patients on twice-a-day insulin regimen: (eg: Novomix 30, Humalog Mix 25 ) Administer half the usual morning insulin dose with breakfast Administer half the evening dose of insulin after the patient has eaten an evening meal (this is to avoid hypoglycaemia as the patient may not prefer to have a normal meal and to ensure that the patient does not vomit or refuse meal) 3. Patients on four-times-a-day insulin regime (ie: basal-bolus) Administer the normal morning insulin dose of short-acting insulin (eg, Humalog, Novorapid, Apidra or Actrapid ) provided the patient eats a light breakfast Continue the same dose of long-acting insulin (whether taken the night before or on the morning of the procedure) Lunchtime on the day of the procedure: Omit lunchtime dose of short-acting insulin Administer half the normal dose of short-acting insulin after the patient has eaten their first meal after the procedure (this is to avoid hypoglycaemia as the patient may not prefer to have a normal meal and to ensure that the patient does not vomit or refuse meal) Page 4 of 5
5 GKI infusions A GKI infusion can be considered during the perioperative period for: Patients with uncontrolled or poorly controlled diabetes (as determined by HbA1c) Patients with type 1 diabetes who are undergoing major surgery Patients who might not be able to start eating normally within 4 hours after surgery The standard GKI regimen: 500mL dextrose 10% with 10mmol potassium chloride and 10units of Actrapid insulin to run at 100mL/hr. The insulin concentration should be varied according to blood glucose levels. In special circumstances (eg, patients with heart failure or those with renal failure who require fluid restriction), a 20% dextrose solution with 20units of insulin with or without potassium chloride, running at 50mL/hr, can be used instead. Please consult the anaesthetist or the surgical team members if there are any doubts or concerns regarding the management of surgical patients with diabetes. Requirements for discharge If the patient has type 1 diabetes, ensure he or she has a blood glucose <15mmol/L before being discharged. For further advice If in doubt, contact the diabetes specialist nurses on ext 2130 (Arrowe Park), ext 4332 (Clatterbridge) or bleep the nurses at either site. References Department of Health (England). National Service Framework for Diabetes: standards. December Available at: (accessed 6 December 2010). British Association of Day Surgery. Day surgery & the diabetic patient: Guidelines for the assessment and management of diabetes in day surgery patients. Colman Print: Norwich; September Page 5 of 5
Surgery and Procedures in Patients with Diabetes
Surgery and Procedures in Patients with Diabetes University Hospitals of Leicester NHS Trust DEFINITIONS Minor Surgery and Procedures: expected to be awake, eating and drinking by the next meal, total
More informationPeri-Operative Guidelines for Management of Diabetes Patients
Peri-Operative Guidelines for Management of Diabetes Patients Target blood glucose 6-10 mmol/l for all patients Acceptable blood glucose 4-11 mmol/l for all patients Definitions Non-Insulin Glucose Lowering
More informationInformation for Patients
Information for Patients Guidance for Diabetic Persons having bowel preparation for a flexible sigmoidoscopy or a colonoscopy or a combined gastroscopy and colonoscopy This guidance is provided to assist
More informationYour blood sugar will be checked on arrival to Endoscopy and monitored whilst you are there.
GASTROSCOPY TABLET CONTROLLED DIABETES (Including injectable medication which is not insulin) MORNING APOINTMENT Take your tablets as normal on the day before the test. On the day of the test: Omit your
More informationGlycaemic Control in Adults with Type 1 Diabetes
Glycaemic Control in Adults with Type 1 Diabetes Aim(s) and objective(s) This document aims to provide guidance on good clinical practice in managing glycaemic control in adult patients with Type 1 Diabetes
More informationA patient s guide to the. management of diabetes at the time of surgery
A patient s guide to the management of diabetes at the time of surgery Diabetes is a common condition, affecting at least 4 to 5% of people in the UK. At least 10% of patients undergoing surgery have diabetes.
More informationUser guide Basal-bolus Insulin Dosing Chart: Adult
Contacts and further information Local contact Clinical pharmacy or visiting pharmacy Diabetes education service Director of Medical Services Visiting or local endocrinologist or diabetes physician For
More informationInsulin onset, peak and duration of action
Insulin onset, peak and duration of action Insulin was first discovered in the early 190 s. Before then, diabetes could not be treated. Insulin was then taken from cow and pig pancreases, but nearly all
More informationROYAL HOSPITAL FOR WOMEN
ROYAL HOSPITAL FOR WOMEN LOCAL OPERATING PROCEDURE CLINICAL POLICIES, PROCEDURES & GUIDELINES Approved by Quality & Patient Safety Committee 17 April 2014 INSULIN INFUSION PROTOCOL INSULIN DEXTROSE INFUSION
More informationElectronic copy to all appropriate staff Intranet Notification in Staff Focus Related Trust Policies (to be read in conjunction with)
Diabetes Management for Children and Young People undergoing Surgery (0-16 yrs) Clinical Guideline Register No: 10096 Status: Public Developed in response to: Updated national guidelines Contributes to
More informationLead Clinician(S) (DATE) Approved by Diabetes Directorate on: Approved by Medicines Safety Group on: This guideline should not be used after end of:
Guideline for members of the diabetes team and dietetic department for advising on insulin dose adjustment and teaching the skills of insulin dose adjustment to adults with type 1 or type 2 diabetes mellitus
More informationTYPE 2 DIABETES SEQUENTIAL INSULIN STRATEGIES
TYPE 2 DIABETES SEQUENTIAL INSULIN STRATEGIES Non-insulin regimes Basal insulin only (usually with oral agents) Number of injections 1 Regimen complexity Low Basal insulin +1 meal-time rapidacting insulin
More informationDiabetes in Pregnancy: Management in Labour
1. Purpose The standard management of labour applies to women with diabetes, and includes the following special considerations: Timing of birth. Refer to guideline: Diabetes Mellitus - Management of Pre-existing
More informationGESTATIONAL DIABETES (DIET/INSULIN/METFORMIN) CARE OF WOMEN IN BIRTHING SUITE
GESTATIONAL DIABETES (DIET/INSULIN/METFORMIN) CARE OF WOMEN IN BIRTHING SUITE DEFINITION A disorder characterised by hyperglycaemia first recognised during pregnancy due to increased insulin resistance
More informationDOCUMENT CONTROL PAGE
DOCUMENT CONTROL PAGE Document Number: GUI/CL/WCN/666 Version Number: Version 2 Title: Guidelines for the management of inpatient diabetes, including the management of diabetic emergencies and the management
More informationTherapy Insulin Practical guide to Health Care Providers Quick Reference F Diabetes Mellitus in Type 2
Ministry of Health, Malaysia 2010 First published March 2011 Perkhidmatan Diabetes dan Endokrinologi Kementerian Kesihatan Malaysia Practical guide to Insulin Therapy in Type 2 Diabetes Mellitus Quick
More informationInpatient Guidelines: Insulin Infusion Pump Management
Inpatient Guidelines: Insulin Infusion Pump Management Developed by the Statewide Diabetes Clinical Network Steering Committee July 2012 Clinical Access and Redesign Unit Table of Contents Purpose...4
More informationThere seem to be inconsistencies regarding diabetic management in
Society of Ambulatory Anesthesia (SAMBA) Consensus Statement on Perioperative Blood Glucose Management in Diabetic Patients Undergoing Ambulatory Surgery Review of the consensus statement and additional
More informationA new insulin order form should be completed for subsequent changes to type of insulin and/or frequency of administration
of nurse A new insulin order form should be completed for subsequent changes to type of insulin and/or frequency of administration 1. Check times for point of care meter blood glucose testing. Pre-Breakfast
More informationINPATIENT DIABETES MANAGEMENT Robert J. Rushakoff, MD Professor of Medicine Director, Inpatient Diabetes University of California, San Francisco
INPATIENT DIABETES MANAGEMENT Robert J. Rushakoff, MD Professor of Medicine Director, Inpatient Diabetes University of California, San Francisco CLINICAL RECOGNITION Background: Appropriate inpatient glycemic
More informationInformation for Starting Insulin Basal-Bolus Regime
Information for Starting Insulin Basal-Bolus Regime Department of Diabetes Page 12 Patient Information Insulin Instructions for Basal Bolus Regimen Two types of insulin are used in this insulin regimen.
More informationResident s Guide to Inpatient Diabetes
Resident s Guide to Inpatient Diabetes 1. All patients with diabetes of ANY TYPE, regardless of reason for admission, must have a Hemoglobin A1C documented in the medical record within 24 hours of admission
More informationONCE ONLY GLUCAGON and Fast Acting Glucose gel (PGD) For nurse administration under Patient Group Direction (Trust wide PGD in place)
ADULT INSULIN PRERIPTION AND BLOOD GLUCOSE MONITORING CHART Ward CONSULTANT DATE OF ADMISSION Please affix Patient s label here Ward Ward.../...year PATIENT NAME....... DATE OF BIRTH... NHS NUMBER.......
More informationTYPE 2 DIABETES MELLITIS (INSULIN AND/OR METFORMIN) CARE OF WOMEN IN BIRTHING SUITE
TYPE 2 DIABETES MELLITIS (INSULIN AND/OR METFORMIN) CARE OF WOMEN IN BIRTHING SUITE DEFINITION Type 2 Diabetes is characterised by insulin resistance and relative impairment of insulin secretion leading
More informationCaring for Diabetics in a Palliative Care setting; The challenges. Dr Simon Pennell. GPwSI Palliative Care.
Caring for Diabetics in a Palliative Care setting; The challenges. Dr Simon Pennell. GPwSI Palliative Care. Diabetes in Palliative Care. What is worth knowing? Likely to seeing more patients with DM +
More informationSection Contents Page 2.1 2 2.2. Contact Details. General Principles
CLINICAL GUIDELINE FOR THE MANAGEMENT OF PAEDIATRIC PATIENTS WITH DIABETES TYPE 1 AND 2 REQUIRING A GENERAL ANAESTHETIC OR SEDATION FOR SURGERY OR ANOTHER PROCEDURE. 1. Aim/Purpose of this Guideline 1.1
More informationSafe use of insulin e- learning module
Safe use of insulin e- learning module Page 1 Introduction Insulin is a hormone produced by the beta cells in the pancreas, it is released when blood glucose levels are raised for example after a meal.
More informationChanging to Basal Bolus Insulin Regimen
Changing to Basal Bolus Insulin Regimen What is a basal bolus insulin regimen? Basal insulin (Lantus) is injected once per day and ensures there is insulin in the body at all times. Bolus insulin (NovoRapid/Humalog)
More informationInsulin switch & Algorithms Rotorua GP CME June 2011. Kingsley Nirmalaraj FRACP Endocrinologist BOPDHB
Insulin switch & Algorithms Rotorua GP CME June 2011 Kingsley Nirmalaraj FRACP Endocrinologist BOPDHB Goal of workshop Insulin switching make the necessary move Ensure participants are confident with Recognising
More informationWorkshop A Tara Kadis
Workshop A Tara Kadis Considerations/barriers in decision making about insulin verses GLP-1 use in people with type 2 diabetes Which Insulin regimes should we consider? Diabetes is a progressive multi-system
More informationPERI OPERATIVE DIABETES MANAGEMENT GUIDELINES AUSTRALIAN DIABETES SOCIETY
PERI OPERATIVE DIABETES MANAGEMENT GUIDELINES AUSTRALIAN DIABETES SOCIETY July 2012 1 Table of Contents FOREWORD... 4 SUMMARY... 5 INTRODUCTION... 6 RATIONALE FOR MAINTENANCE OF EUGLYCAEMIA... 6 TARGETS
More informationAn introduction to carbohydrate counting
An introduction to carbohydrate counting Delivering the best in care UHB is a no smoking Trust To see all of our current patient information leaflets please visit www.uhb.nhs.uk/patient-information-leaflets.htm
More informationCLASS OBJECTIVES. Describe the history of insulin discovery List types of insulin Define indications and dosages Review case studies
Insulins CLASS OBJECTIVES Describe the history of insulin discovery List types of insulin Define indications and dosages Review case studies INVENTION OF INSULIN 1921 The first stills used to make insulin
More informationINSULIN INITIATION IN TYPE 2 DIABETES IN PRIMARY CARE
INSULIN INITIATION IN TYPE 2 DIABETES IN PRIMARY CARE We welcome feedback on this policy and the way it operates. We are interested to know of any possible or actual adverse impact that this policy/procedure
More informationInsulin/Diabetes Calculations
Insulin/Diabetes Calculations Dr. Aipoalani St Lukes Endocrinology Goals Describe various calculations for insulin dosing Understand importance of the total daily dose (TDD) of insulin Be able to calculate
More informationType 2 Diabetes: When to Initiate And Intensify Insulin Therapy. Julie Bate on behalf of: Dr John Wilson Endocrinologist Capital and Coast DHB
Type 2 Diabetes: When to Initiate And Intensify Insulin Therapy Julie Bate on behalf of: Dr John Wilson Endocrinologist Capital and Coast DHB Declarations I have received travel funding and speaker fees
More informationUniversity Hospitals of Leicester NHS Trust. Carbohydrates. A guide to carbohydrate containing foods for people with diabetes
University Hospitals of Leicester NHS Trust Carbohydrates A guide to carbohydrate containing foods for people with diabetes This information is designed to help you to understand how carbohydrates affect
More information81 Central Street, Houghton Estate, 2198 PO Box 2900, Saxonwold, 2132 www.cdediabetes.co.za
81 Central Street, Houghton Estate, 2198 PO Box 2900, Saxonwold, 2132 www.cdediabetes.co.za Clinical Guidelines 2015 The Use of Antibody Testing in the Management of Diabetes Mellitus When should the Antibody
More informationManaging the U Managing the U--500 500 Patient as a Surg as a Sur ical Inpatient
Managing the U-500 Patient as a Surgical Inpatient Tyler Fischback Pharmacy Specialist St. Clare Hospital I have no conflicts of interest to disclose The Case DM is a 37 y.o.. developmentally delayed T2DM
More informationDiabetes How to manage illness
York Teaching Hospital NHS Foundation Trust Diabetes How to manage illness For adults with Type 1 diabetes on a basal bolus insulin regime For more information, please contact: Diabetes and Endocrinology
More informationEnd of Life Diabetes Care
End of Life Diabetes Care Commissioned by Diabetes UK Supplementary Documents and Flowcharts Endorsed By: Diabetes Phases of End of Life and Medications A - Blue: All From Diagnosis Stable With Year Plus
More informationA Guide to Monitoring Blood Glucose for Patients with diabetes in Care Homes
A Guide to Monitoring Blood Glucose for Patients with diabetes in Care Homes 1. Summary... 1 2. Background... 2 3. Purpose 2 4. Responsibilities. 2 5. Blood Glucose Monitoring. 2 6. Resident Groups that
More informationInsulin Pump Therapy
CHILDREN S SERVICES Insulin Pump Therapy These guidelines are not intended for starting a patient on an insulin pump. They are intended to give staff not part of the diabetic team information regarding
More informationIntensive Insulin Therapy in Diabetes Management
Intensive Insulin Therapy in Diabetes Management Lillian F. Lien, MD Medical Director, Duke Inpatient Diabetes Management Assistant Professor of Medicine Division of Endocrinology, Metabolism, & Nutrition
More informationGuideline for Insulin Therapeutic Review in patients with Type 2 Diabetes
Diabetes Sans Frontières Guideline for Insulin Therapeutic Review in patients with Type 2 Diabetes 1. Introduction This guideline has been developed in order to support practices to undertake insulin therapeutic
More informationManagement of Children with newly diagnosed type 1 diabetes (up until their 18th Birthday)
Title: Author: Speciality / Division: Directorate: CLINICAL GUIDELINES ID TAG Management of Children with newly diagnosed type 1 diabetes (up until their 18th Birthday) Dr Teresa Mulroe and Dr Sarinda
More informationScottish Medicines Consortium
Scottish Medicines Consortium insulin glulisine for subcutaneous injection 100 units/ml (Apidra ) No. (298/06) Sanofi Aventis 4 August 2006 The Scottish Medicines Consortium (SMC) has completed its assessment
More informationIntroduction. We hope this guide will aide you and your staff in creating a safe and supportive environment for your students challenged by diabetes.
Introduction Diabetes is a chronic disease that affects the body s ability to metabolize food. The body converts much of the food we eat into glucose, the body s main source of energy. Glucose is carried
More informationWhen and how to start insulin: strategies for success in type 2 diabetes
1 When and how to start insulin: strategies for success in type diabetes Treatment of type diabetes in 199: with each step treatment gets more complex Bruce H.R. Wolffenbuttel, MD PhD Professor of Endocrinology
More informationDIABETES - INSULIN INITIATION - BACKGROUND INFORMATION (1)
DIABETES - INSULIN INITIATION - BACKGROUND INFORMATION (1) KEY PRINCIPLES Many patients with Type 2 diabetes will require insulin therapy. In the UKPDS over 50% of patients by 6 years required additional
More informationInformation for Patients with Diabetes having Lower Endoscopic Investigations requiring full bowel preparation
York Teaching Hospital NHS Foundation Trust Information for Patients with Diabetes having Lower Endoscopic Investigations requiring full bowel preparation Morning Appointment Information for patients,
More informationManagement of adults with diabetes undergoing surgery and elective procedures: improving standards
Surgical outpatients Hospital admission Theatre and recovery Discharge Primary care referral Pre-operative assessment Post-operative care Management of adults with diabetes undergoing surgery and elective
More informationDiabetes Information
Diabetes Information Your diabetes team includes: Consultant Paediatric Endocrinologist Paediatric Diabetes Clinical Nurse Specialists Senior Clinical Nutritionists/Dietitians Senior Clinical Psychologist
More informationIntroduction to Insulin Pump Therapy
Introduction to Insulin Pump Therapy What is an insulin pump and how does it work? An insulin pump is a small electronic device which provides a continuous infusion of very fast acting insulin (Novorapid
More informationNSW Adult Subcutaneous Insulin Prescribing Chart User Guide
NSW Adult Subcutaneous Insulin Prescribing Chart User Guide Adult Subcutaneous Insulin Prescribing Chart User Guide - 13 August 2013 Contents Target audience:... 1 Exceptions:... 1 1. Introduction... 2
More informationType: Clinical Guideline. Management of the newly diagnosed child with Diabetes Mellitus. Register No: 11022 Status: Public
Management of the newly diagnosed child with Diabetes Mellitus. Type: Clinical Guideline Register No: 11022 Status: Public Developed in response to: Guideline Review Contributes to CQC Regulation 9,12
More informationRapid Response Report NPSA/2010/RRR013: Safer administration of insulin
Rapid Response Report NPSA/2010/RRR013: Safer administration of insulin June 2010 Supporting Information Contents 1. Introduction...2 2. Background...2 3. Review of evidence of harm...4 References...7
More informationThe What, Why, Who & How of Insulin Pumps. Bridget Lydon May 2014
The What, Why, Who & How of Insulin Pumps Bridget Lydon May 2014 Topics WHAT is an insulin pump HOW a pump works WHY use a pump WHO should use a pump Pharmac criteria for funded pumps All began back in
More informationInsulin Safety. The safe use of insulin and you. Patient Information Booklet
Insulin Safety The safe use of insulin and you The Right insulin The Right dose The Right way The Right time Hypoglycaemia Diabetes Patient Information Booklet Adapted from the National Patient Safety
More informationGuideline for the Management of Diabetes Mellitus in Palliative Medicine
Guideline for the Management of Diabetes Mellitus in Palliative Medicine Date Approved by Network Governance July 2012 Date for Review July 2015 Changes between versions 1 and 2 Page 7 last bullet point
More informationAdvanced Carbohydrate Counting
Advanced Carbohydrate Counting Living Well with Your Health Conditions What is Carbohydrate Counting? Carbohydrate counting focuses on the amount of carbohydrate (carbs) in your diet. Carbohydrate is the
More informationA Simplified Approach to Initiating Insulin. 4. Not meeting glycemic goals with oral hypoglycemic agents or
A Simplified Approach to Initiating Insulin When to Start Insulin: 1. Fasting plasma glucose (FPG) levels >250 mg/dl or 2. Glycated hemoglobin (A1C) >10% or 3. Random plasma glucose consistently >300 mg/dl
More informationHyperosmolar Non-Ketotic Diabetic State (HONK)
Hyperosmolar Non-Ketotic Diabetic State (HONK) University Hospitals of Leicester NHS Trust Guidelines for Management of Acute Medical Emergencies Management is largely the same as for diabetic ketoacidosis
More informationKaiser Sunnyside Medical Center Inpatient Pharmacy Manual
Page: 1 of 10 PURPOSE To provide a standard procedure for optimizing care of the inpatient with hyperglycemia and/or diabetes. Substantially provide safe and effective glucose control for all adult inpatients.
More informationFORWARDHEALTH PRIOR AUTHORIZATION / PREFERRED DRUG LIST (PA/PDL) FOR HYPOGLYCEMICS, INSULIN LONG-ACTING
DEPARTMENT OF HEALTH SERVICES STATE OF WISCONSIN Division of Health Care Access and Accountability Wis. Admin. Code DHS 107.10(2) FORWARDHEALTH PRIOR AUTHORIZATION / PREFERRED DRUG LIST (PA/PDL) FOR HYPOGLYCEMICS,
More informationDiabetes Expert Witness on: Diabetic Hypoglycemia in Nursing Homes
Diabetes Expert Witness on: Diabetic Hypoglycemia in Nursing Homes Nursing home patients with diabetes treated with insulin and certain oral diabetes medications (i.e. sulfonylureas and glitinides) are
More informationUnderstanding Your Diabetes HELPLINE: 01604 622837 www.iddtinternational.org
I ndepend ent DI abetes t rust Understanding Your Diabetes HELPLINE: 01604 622837 www.iddtinternational.org INDEPENDENT DIABETES TRUST The Trust offers support, understanding and information to people
More informationBlood Glucose - How to test
Blood Glucose - How to test no nurse should use blood glucose monitoring equipment without complete training the ward manager is responsible for ensuring staff are trained in Blood Glucose testing Calibration
More informationDiabetes Management Tube Feeding/Parenteral Nutrition Order Set (Adult)
Review Due Date: 2016 May PATIENT CARE ORDERS Weight (kg) Known Adverse Reactions or Intolerances DRUG No Yes (list) FOOD No Yes (list) LATEX No Yes ***See Suggestions for Management (on reverse)*** ***If
More informationSelf-Monitoring Of Blood Glucose (SMBG)
Self-Monitoring Of Blood Glucose (SMBG) Aim(s) and objective(s) It is important is to ensure that people with Diabetes are given the opportunity to self monitor their blood glucose appropriately as an
More informationHow to adjust your insulin if taken two or three times daily. To change the insulin dose, you will need to know:
What to do if your results are too high or too low The target range for your blood glucose results is from to 8 mmol/l - aim to have four out of every five blood glucose results in this range. If three
More informationeducation Insulin delivery devices Paper Current insulin preparations Discovery of insulin and key developments in preparations
Paper 2009 Royal College of Physicians of Edinburgh Insulin delivery devices 1 AJ Graveling, 2 EA McIntyre 1 Specialty Registrar; 2 Consultant, Department of Diabetes & Endocrinology, Monklands Hospital,
More informationDiabetes: When To Treat With Insulin and Treatment Goals
Diabetes: When To Treat With Insulin and Treatment Goals Lanita. S. White, Pharm.D. Director, UAMS 12 th Street Health and Wellness Center Assistant Professor of Pharmacy Practice, UAMS College of Pharmacy
More informationDiabetes Subcommittee of PTAC meeting. held 18 June 2008. (minutes for web publishing)
Diabetes Subcommittee of PTAC meeting held 18 June 2008 (minutes for web publishing) Diabetes Subcommittee minutes are published in accordance with the Terms of Reference for the Pharmacology and Therapeutics
More informationType 1 Diabetes Management Based on Glucose Intake www.utmem.edu/endocrinology click Patients (Revised 7/13/2007)
Type 1 Diabetes Management Based on Glucose Intake www.utmem.edu/endocrinology click Patients (Revised 7/13/2007) The following is a system of insulin therapy, diet management, and blood glucose monitoring
More informationInsulin Pump Workbook
Insulin Pump Workbook Local Phone Numbers: Pump manufacturers helpline: Developed by Joan Everett and Dr Helen Lockett on behalf of Diabetes Education Network 1 Page 3 Page 4 Page 5 Page 6 Page 7 Page
More informationYour diabetes: Understanding your blood glucose test results. Information for patients Diabetes Service. HbA1c. Large Print. What is the HbA1c test?
Your diabetes: Understanding your blood glucose test results This leaflet explains about the different ways your diabetes blood glucose control is measured. Knowing the level of glucose in your blood is
More informationINSULIN INTENSIFICATION: Taking Care to the Next Level
INSULIN INTENSIFICATION: Taking Care to the Next Level By J. Robin Conway M.D., Diabetes Clinic, Smiths Falls, ON www.diabetesclinic.ca Type 2 Diabetes is an increasing problem in our society, due largely
More informationInsulin Dose Adjustment REAL-Time CGMS Guidelines for Subjects on Pump Therapy
Insulin Dose Adjustment REAL-Time CGMS Guidelines for Subjects on Pump Therapy In addition to using the blood sugar logs to adjust your insulin doses every week, you should also use your continuous glucose
More informationSAMPLE. iabetes insulin use it safel. A patient information booklet for adults who have diabetes and use insulin. Diabetes: insulin, use it safely
urther information Read this booklet and the Insulin Passport alongside all the other information about diabetes that your diabetes nurse or doctor has given to you. You will also need to read the technical
More informationInsulin use in Type 2 Diabetes. Dr Rick Cutfield. Why? When? How?
Insulin use in Type 2 Diabetes Dr Rick Cutfield Why? When? How? 1 Conflict of Interest I have been on advisory boards or had speaker fees from the following pharmaceutical companies: - Eli Lilly - Novo
More informationMANAGEMENT OF DIABETIC PATIENTS IN RADIOLGY. Edition 2
MANAGEMENT OF DIABETIC PATIENTS IN RADIOLGY Edition 2 Author, Authority Clinical Director Date of Origin December 2007 Date of Review November 2009 Scope of Authority, (Trust, other) Trust Total pages
More informationClinical Solutions in Diabetes Care 2008 Insulin Adjustment
Clinical Solutions in Diabetes Care 2008 Insulin Adjustment Helen Cressey and Clare MacArthur Helen Gibson and Moira Digby Welcome! First, an introduction with a few facts Some research Some considerations
More informationInsulin pens workshop Making the complex simple
Agenda: Insulin doses Needles Insulin Pen Devices Insulin storage Key information (Patient &HCP) Injection sites Hypoglycaemia Home blood glucose testing Sick day advice Traveling Sharps Insulin pens workshop
More informationSteroid Therapy and Management of Hyperglycaemia
Steroid Therapy and Management of Hyperglycaemia Table of Contents Rationale...1 Scope of guidelines...2 Outcome statement...2 Aims of management...2 Effects of glucocorticoids...2 Types of steroids commonly
More informationClinical and cost-effectiveness of continuous subcutaneous insulin infusion therapy in diabetes.
PROTOCOL Clinical and cost-effectiveness of continuous subcutaneous insulin infusion therapy in diabetes. A. This the revised protocol (April 2002) B. Review team Contact for correspondence: Dr Jill Colquitt
More informationGestational Diabetes. A Guide to Insulin in Pregnancy
Gestational Diabetes A Guide to Insulin in Pregnancy Why do I need insulin? It is important for your baby that your blood glucose stays below 5.5 mmols before breakfast and below 7 two hours after meals
More informationDiabetesMeter User Manual
DiabetesMeter User Manual 1. THE GENERAL OUTLINE DiabeticMeter is an application for people suffering from insulin-dependent diabetes. It provides support in taking day-to-day decisions regarding products
More informationA Guide to Starting. Humalog Mix25
A Guide to Starting Humalog Mix25 This booklet is intended only for those individuals who have been prescribed Humalog Mix 25. It is intended to be used in addition to the Patient Information Leaflet (PIL)
More informationNHS FORTH VALLEY Adult Adrenal Insufficiency Management Guidelines
NHS FORTH VALLEY Adult Adrenal Insufficiency Management Guidelines Date of First Issue 01 August 2006 Approved 01 August 2006 Current Issue Date 30 th May 2014 Review Date 1 st July 2018 Version 1.2 EQIA
More informationDiabetes Monitoring Diary
Diabetes Monitoring Diary For those Counting Diabetes Service My targets: Before breakfast Before other meals Before bed... mmol/l... mmol/l... mmol/l Correcting high blood glucose levels: Information
More informationAn estimated 280 Australians develop diabetes every day. It is Australia s fastest-growing chronic disease.
Diabetes and insulin Summary Even with the help of your doctor and diabetes nurse educator, it may take a while to find the right insulin dose to reduce your blood glucose to your target levels. Insulin
More informationManaging the Hospitalized Patient on Insulin: Care Transition. Catie Prinzing MSN, APRN, CNS
Managing the Hospitalized Patient on Insulin: Care Transition Catie Prinzing MSN, APRN, CNS Diabetes and Hospitalization People with DM are hospitalized 3x more frequently than patients without diabetes
More informationInsulin Pump Therapy Management Guideline
Insulin Pump Therapy Management Guideline Greater Glasgow & Clyde Children s Diabetes Service Royal Hospital for Sick Children, Glasgow Inverclyde Royal Hospital, Greenock Royal Alexandra Hospital, Paisley
More informationP A T I E N T I N F O R M A T I O N. Apidra
P A T I E N T I N F O R M A T I O N Apidra We have written this leaflet for those of you with diabetes who have been prescribed Apidra by your doctor. The primary goal of all diabetes treatment is to achieve
More information10 to 30 minutes ½ to 3 hours 3 to 5 hours. 30 60 minutes 1 to 5 hours 8 hours. 1 to 4 hours
Insulin Action There are several types of insulin. They are classified by how long they act: very fast, fast, slow and very slow acting. Each type of insulin has a certain time period in which it works.
More informationTYPE 2 DIABETES CRITERIA FOR REFERRAL TO LEVEL 2 OOHS
TYPE 2 DIABETES CRITERIA FOR REFERRAL TO LEVEL 2 OOHS The aim of the Diabetes level 2 service is to provide a high quality service for safe initiation and optimization of injectable therapy within GP networks.
More informationPrior Authorization Guideline
Prior Authorization Guideline Guideline: PC - Apidra, Levemir Therapeutic Class: Hormones and Synthetic Substitutes Therapeutic Sub-Class: Antidiabetic Agents Client: CA, CO, NV, OK, OR, WA and AZ Approval
More informationThe Leeds Insulin Pump Workbook for Children and Young People
The Leeds Insulin Pump Workbook for Children and Young People IABETES LEEDS YORKSHIRE A service for children and young people with diabetes This project has received funding from Medtronic Contents Welcome
More informationThe Leeds Insulin Pump Workbook for Children and Young People
The Leeds Insulin Pump Workbook for Children and Young People IABETES LEEDS YORKSHIRE A service for children and young people with diabetes This project has received funding from Medtronic Contents Welcome
More information