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Specialist diabetes teams must be 'embedded' in all hospitals

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The UK’s leading specialist in diabetes inpatient care has called on the NHS to take immediate action to raise standards of care in hospitals for people with diabetes.

He said action must be taken to raise standards of acute care for diabetes patients by ensuring specialist inpatient diabetes teams were “embedded” in all hospitals.

“Over 30% of hospitals do not even have an inpatient diabetes specialist nurse”

Gerry Rayman

Dr Gerry Rayman is head of service at Ipswich Hospital NHS Trust’s diabetes centre, lead for the National Diabetes Inpatient Audit and a specialist medical advisor to the charity Diabetes UK.

He has advised that a new approach is needed to tackle the almost 8-10% higher mortality rate among inpatients with diabetes than other patients.

Speaking at a Diabetes UK conference this week, Dr Rayman said hospital managers and diabetes specialists must work together to implement hospital-wide safety practices.

It should mirror the approach already taken for conditions such as stroke, he said, adding that it would lead to much safer care for diabetes patients when they were admitted, reduce the length of hospital stays, and bring about considerable financial savings.

Dr Rayman noted that one in five inpatients with diabetes experienced blood glucose levels falling dangerously low, 37% experienced medication errors, and cases of diabetic ketoacidosis had not been reduced.

He said: “Too few hospitals have fully-staffed inpatient diabetes teams, and over 30% of hospitals do not even have an inpatient diabetes specialist nurse.

“We need a commitment and a concerted effort made now, across all hospitals, driven forward by hospital leaders including both managers and clinicians, to provide a high level of care for inpatients with diabetes,” he said. “It is clear this will be cost effective.”

Ipswich Hospital NHS Trust

Dr Gerry Rayman

Barbara Young, chief executive of Diabetes UK, highlighted that specialist teams played a “crucial role” in providing care for complex cases and delivered “essential” education to all staff.

“This includes things like working with general ward nurses and healthcare assistants to ensure that patients are supported to monitor their blood glucose levels, have their feet checked every day for ulcers, and have meals that are suitable and given at the right times to ensure good glucose control,” she said.

“We want the NHS to take immediate action to make sure every hospital has a fully-staffed specialist inpatient diabetes team,” she added.

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