Diabetes--big problem, little confidence

Abstract

The first time I increased a patient’s insulin dose, I lay awake all night worrying he might become hypoglycaemic. I was a house officer and had had little training in the practical management of diabetes. The patient slept well and safely. It is estimated that 7.4% of the English population over 16 years of age have diabetes and that this will increase to 9.5% in 2030.1 In England, 12% of deaths in people aged 20–79 years can be attributed to diabetes.2 Hospital in-patient beds of 10–20% are occupied by people with diabetes. A cross-sectional audit of adults with diabetes in 219 UK hospitals in 2009 included 14 259 in-patients. In all, 19% had drug errors and 14% diabetes management errors. After admission, 124 patients developed new diabetic ketoacidosis (DKA), and 303 developed new foot problems.3 The 2010 audit is currently in analysis. Results will be available by named hospital on the National Diabetes Information Service (NDIS) web site in April 2011.4 The National Patient Safety Agency (NPSA) has now received over 16 000 reports of insulin incidents, mostly from hospitals.5 They …