The Ambulatory Insulin Stabilisation program is coordinated by the Diabetes Education service and is an intensive process of concurrent assessment, insulin adjustment, education and skill development without a hospital admission of the patient.
The goal of the program is to assist the person in achieving a desired blood glucose target within a specified period of time. This requires input from the multidisciplinary team consisting of a medical officer, diabetes clinical nurse consultant (CNC) and dietitian.
Individuals are normally be enrolled in the program for a period of 6 weeks, after which time they will be discharged to their usual care or may require further medical review.
- Patients must perform a specified number of blood glucose tests. The diabetes CNC ensures that they have the necessary equipment and are competent to use it
- Patients must call the diabetes education service weekly on a specified day and time. The diabetes CNC determines if more frequent contact is required in specific circumstances (e.g. illness)
- Program duration is 6 weeks
- Patient's skills and competence is assessed continually
- Patients who do not reach targets during the program are referred back to the referring doctor
- GPs are sent a letter when their patient starts and successfully completes the stabilisation process
- Discharge from the program is documented in their medical record and electronic diabetes survey
The program is available to RMH patients who have either:
- Newly commenced on insulin therapy
- Undergone a change in their insulin regimen
- Concurrent steroid or oncology treatment affecting glycaemia
Eligible patients must also either:
- Be admitted under the Diabetes and Endocrinology service or Diabetic Foot Unit
- Had a consultation by the RMH endocrinology team during their hospital presentation
- Attend one of the diabetes or endocrine clinics at RMH
Documented assessment of the person’s ability to demonstrate various skills and knowledge is a pre-requisite for enrolment in the program.
Individuals receiving RDNS for insulin management cannot be referred for this service (RDNS require an order written by a medical officer).