SL73-Managing Service Users Living with Diabetes

Registration Number: {{org_field_registration_no}}

Managing Service Users Living with Diabetes

1. Purpose

At {{org_field_name}}, we are committed to providing safe, effective, and person-centred care for individuals living with diabetes. Our approach ensures that individuals receive appropriate support in managing their condition while maintaining independence and quality of life.

This policy aligns with CQC regulations, NICE Guidelines for Diabetes Management, the Care Act 2014, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and the Mental Capacity Act 2005. It provides clear guidance on diabetes management, including blood glucose monitoring, insulin administration, dietary support, and emergency response to diabetic complications.

2. Scope

This policy applies to all staff, including permanent, temporary, agency, and volunteer workers who provide direct or indirect support to individuals living with diabetes in our Supported Living service. It covers Type 1 and Type 2 diabetes, as well as management strategies for individuals with additional health conditions.

3. Related Policies

SL12 – Safe Care and Treatment Policy
SL07 – Person-Centred Care Policy
SL21 – Medication Management and Administration Policy
SL16 – Infection Prevention and Control Policy
SL08 – Dignity and Respect Policy
SL34 – Confidentiality and Data Protection (GDPR) Policy
SL13 – Safeguarding Adults from Abuse and Improper Treatment Policy

4. Principles of Diabetes Management

4.1 Person-Centred Diabetes Care

Support should be tailored to meet individual needs, preferences, and lifestyle choices.
Care plans should be developed with input from healthcare professionals, individuals, and (where appropriate) families or advocates.
Individuals should be encouraged to self-manage their diabetes where possible, with appropriate support.
Clear communication is essential to ensure that individuals understand their condition, treatment, and management options.
Always follow the care plan and advice given by the professionals involved.

4.2 Blood Glucose Monitoring

Staff should support individuals to monitor their blood glucose levels as prescribed by their healthcare professional.
If staff are required to assist with blood glucose testing, they must:
- Follow infection control procedures.
- Use the individual’s own blood glucose monitor and lancets.
- Record blood glucose readings accurately in the individual’s health records.
Any unusual or concerning readings must be reported to healthcare professionals immediately.

4.3 Insulin Administration and Medication Management

Insulin administration must be carried out only by trained staff who have completed competency assessments.
Staff must follow the Medication Management and Administration Policy (SL21) to ensure the safe storage, handling, and administration of insulin and other diabetes medications.
Insulin should be stored in a temperature-controlled environment (refrigerated at 2-8°C) and checked for expiry dates before administration.
Any missed doses or medication errors must be reported immediately and documented appropriately.

4.4 Diet and Nutrition Support

Staff should support individuals to maintain a balanced diet tailored to their diabetes needs.
Meal planning should be in line with dietary recommendations from healthcare professionals, including:
- Low glycaemic index (GI) foods to regulate blood sugar levels.
- Appropriate carbohydrate intake to prevent blood sugar fluctuations.
- Healthy fats and protein to support overall health.
Individuals must be supported to make informed choices about their diet, and staff should encourage hydration and regular meals.

4.5 Physical Activity and Lifestyle Support

Staff should encourage regular physical activity as recommended by healthcare professionals.
Individuals should be supported to engage in exercise routines suited to their ability and health conditions.
Weight management and smoking cessation support should be offered where necessary to reduce diabetes-related complications.

4.6 Preventing and Managing Hypoglycaemia (Low Blood Sugar)

Signs of hypoglycaemia include:
- Shakiness, dizziness, and sweating.
- Confusion or irritability.
- Sudden hunger or nausea.
- Weakness or tiredness.
Immediate response to hypoglycaemia:
- Offer a fast-acting carbohydrate such as glucose tablets, fruit juice, or a sugary snack.
- Follow up with a longer-acting carbohydrate (e.g., a sandwich or biscuit) to maintain stable blood sugar levels.
- If the individual becomes unconscious, call emergency services (112 or 999) immediately.

4.7 Preventing and Managing Hyperglycaemia (High Blood Sugar)

Signs of hyperglycaemia include:
- Increased thirst and dry mouth.
- Frequent urination.
- Fatigue or blurred vision.
- Fruity-smelling breath (a sign of diabetic ketoacidosis – medical emergency).
Immediate response to hyperglycaemia:
- Encourage hydration and physical activity (if appropriate).
- Check blood glucose levels and administer prescribed insulin if directed.
- If blood sugar remains high or the individual appears unwell, seek urgent medical advice.

4.8 Diabetic Foot Care

Individuals with diabetes must receive regular foot checks to prevent diabetic foot ulcers and infections.
Staff must support individuals in daily foot hygiene, checking for cuts, sores, swelling, or changes in skin colour.
Referral to a podiatrist or GP must be made if any foot issues are identified.

4.9 Diabetes-Related Emergencies

Diabetic Ketoacidosis (DKA):
- Symptoms: Extreme thirst, vomiting, confusion, fruity breath, deep breathing.
- Immediate action: Call 112 or 999 for emergency medical support.
Hyperosmolar Hyperglycaemic State (HHS):
- Symptoms: Severe dehydration, extreme fatigue, confusion.
- Immediate action: Ensure the individual drinks fluids and seek urgent medical attention.

5. Staff Training and Competency

All staff must receive diabetes awareness training as part of their induction and annual refresher training.
Staff supporting individuals with diabetes must receive additional training in:
- Blood glucose monitoring and insulin administration.
- Recognising and responding to diabetic emergencies.
- Dietary support and lifestyle interventions.
- Foot care and preventing complications.
Competency assessments must be conducted annually to ensure staff remain compliant with best practices.

6. Record-Keeping and Documentation

Daily logs must be maintained for:
- Blood glucose readings.
- Insulin administration and medication records.
- Dietary and fluid intake monitoring (if required).
- Incidents of hypo/hyperglycaemia and emergency interventions.
Care plans must be regularly reviewed and updated to reflect any changes in the individual’s condition or treatment plan.

7. Confidentiality and Data Protection

All diabetes-related health records must be stored securely in compliance with GDPR and Confidentiality Policies (SL34).
Health information must only be shared with authorised healthcare professionals and caregivers on a need-to-know basis.

8. Monitoring and Continuous Improvement

Regular care audits and reviews must be conducted to ensure compliance with diabetes management protocols.
Feedback from individuals receiving support and healthcare professionals must be used to improve diabetes care practices.
Lessons learned from incidents (e.g., medication errors, hospital admissions) should be incorporated into staff training and policy updates.

9. Policy Review

This policy will be reviewed annually or sooner if required due to:

Changes in CQC regulations or NICE guidelines.
New best practices in diabetes management.
Feedback from staff, individuals, and healthcare professionals.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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