Secondary Care

Education for general staff

Health Improvement Scotland have developed five on-line modules for staff who care for people with diabetes in secondary care. These courses cover key aspects of clinical care that are relevant, regardless of the care setting. They can also be accessed through Learn Pro. The modules relate to:
Module 1: Introduction to In-patient diabetes
Module 2: Insulin administration
Module 3: How to prevent and manage hypoglycaemia
Module 4: Subcutaneous insulin management
Module 5: Intravenous Insulin

The safe and effective management of hypoglycaemia in hospitals is facilitated by the use of “hypo” boxes maintained within each ward. A protocol has been agreed for the management of diabetes within hospitals. Further information is available on the Diabetes in Scotland website.

  • The NHS Diabetes guideline on the management of patients undergoing surgery has been generally accepted for use within Scotland though there are issues with the availability of some specific intravenous fluids.
  • The SLWG supports the widespread uptake of the Safe Use of insulin elearning module in as many acute clinical areas as possible.
  • The group supports the development of a Scottish insulin prescription and recording chart and are working with others to pilot this.

Other relevant clinical aspects

There are various resources to support the management of people with, or at risk of, diabetic ketoacidosis.

A ketocard gives guidance on how to self manage diabetic ketocacidosis.

A ketoacidosis care pathway has been developed for clinical practice.
Diabetic ketoacidosis care pathway 1 0-4 hours Emergency Management.
Diabetic ketoacidosis care pathway 2 4 hours to discharge.
An audit tool has been developed for diabetic ketoacidosis bundles : Audit tool for DKA bundles.

Palliative Care

Diabetes UK have launched an end of life care strategy.

CPR for Diabetic Feet

The Scottish Diabetes Foot Action Group (SDFAG) is currently working on a National initiative called CPR for Diabetic feet. A LearnPro module is available to support this initiative and can be found on the LearnProNHS website under the CPD section. A training manual, poster and pressure relief algorithm are also available on the Diabetes in Scotland website.