The self-administration of insulin while in hospital (adults)
Supporting patients to self-manage their diabetes while in hospital
Self-administration of insulin on the ward
This page contains information for patients from the Inpatient Diabetes team. We hope the following information will be helpful to you. If you have any questions regarding this information, please do not hesitate to contact the Diabetes Specialist Nurses on:
Lancaster: 01524 512413
Barrow/Kendal: 01229 404445
Self-management of your diabetes.
If you have diabetes treated with insulin and are admitted to hospital, you will be asked whether you wish to continue to make your own decisions about the management of your diabetes during your admission, if you are feeling well enough to do so.
As you are the person with most experience in caring for your diabetes, we would encourage you to continue to make your own decisions about your treatment wherever possible. If you choose not to self-manage during your admission, medical and nursing staff will take decisions on your behalf but wherever possible you will be consulted.
Why self-administer insulin in hospital?
Self-administration of insulin can lead to better timing of doses and better blood glucose levels (Joint British Diabetes Society, 2021). However, insulin can be dangerous if an incorrect dose is administered.
Your nurse will need to assess whether it is safe for you to administer your own insulin doses while you’re in hospital.
It may not be safe if you are very unwell or if other changes have been made to your treatment. For example, sometimes in hospital, you might be given medications, such as steroids, which may affect your blood glucose level. During this time, it may not be safe for you to administer your usual insulin doses.
The nurse will also need to ask you some questions to check that you understand insulin, the doses you need and how to do your injections.
Further information on self administration can be found at:
The joint British Diabetes Society for inpatient care (2021): 'Self management of diabetes in hospital' https://abcd.care/files/site_uploads/JBDS_Guidelines_Current/JBDS_04_Self_Management_Updated_August_2021.pdf
Alternatively, you can ask your Diabetes Specialist Nurse for a copy of this information.
We ask that for your safety and the safety of the other patients, you must:
- Sign the patient self-administration agreement form provided by your nurse.
- Store your insulin out of sight in your bedside locker in the plastic box provided.
- Dispose of any used needles immediately after use in the yellow sharps container provided. Do not leave needles attached to your pen. Please ask a member of staff if a container has not been made available.
- Record the dose of insulin that you gave on the insulin chart provided to you (you can also record your blood glucose readings on this chart)
- 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.
Tell your nurse if the blood glucose reading on your meter is less than 4mmol or higher than 12mmol and they will check the result on the ward meter.
Can I monitor my own blood glucose level?
We will monitor your blood glucose using the ward meters which are very accurate, but you can also use your own meter if you want to.
Please be aware that while in hospital the nursing team will need to also use their meter to record your blood glucose levels. This is a legal requirement.
The hospital uses capillary blood glucose testing (finger prick tests) and these will differ in blood glucose readings from freestyle libre/dexcom. Flash glucose/continuous monitoring uses a different method of monitoring using interstitial fluid and this reading cannot be used to dose your medications.
If any changes are needed to your insulin doses, the doctors will need to use the hospital blood glucose readings to monitor.
If you require a CT or MRI scan you will need to remove your libre/dexcom sensor and pump if using one.
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 and a discharge summary will be sent to your General Practitioner (GP).
If you have any questions regarding your insulin dose while you are in hospital, please speak to your nurse who will direct you to the most appropriate person if they cannot help.
If the medical condition for which you were admitted means that you are not well enough to make your own decisions (for example if you need sedation or if you need to be treated with intravenous insulin), medical and nursing staff will take over the management of your diabetes until you feel ready to look after yourself.
If you wish to take responsibility for managing your diabetes during your admission you will be asked to sign a form to confirm this. You will also be asked to keep a record of your blood glucose levels and the insulin you have taken so that medical and nursing staff are aware of the decisions you have taken. If you would like to see a member of the diabetes team during your admission, please inform the nursing staff.
Diabetes Specialist Nurses:
Lancaster: telephone 01524 512413
Barrow/Kendal: telephone 01229 404445