Disappointed with NHS care of mum today

Hello, oh dear, I’m so sorry and I’m quite surprised they didn’t know how to administrate glucose. Is your mum better now? I was told that when someone is unconscious, even glucose gel is dangerous because of choking. They should have a glucagen kit? Or administrate glucose through an injection? I was unconscious and paramedics didn’t put anything in my mouth, they injected into my veins. Usually you can get them on prescription, maybe you can ask your mum's diabetes team or GP for information on it. I’ll tag @Mel dCP

Having no experience personally of insulin you might want to remember this in what I am to say but if it were my mum I’d want to know
How it happened? (Too much insulin given? Readings not checked?) it should all be documented
Why they treated it the way they did?
Who is administering her insulin?
Are they following her normal regime?
If not who ordered the changes and why?
Has the hospital diabetic team seen her? If not why not?
What is she eating? Does she carb count? Does she have access to the right info to do this?

Some questions might have valid replies but this is where I’d start

I am not surprised this happened over a weekend.

8 years ago my 78 year old T1 mother was in a general ward (in the South of England, she didn't want me to complain about the hospital so it shall remain nameless for now) after 10 days in intensive care, with multiple organ failure.
She was in recovery, so not surprisingly her insulin needs went down from the high (for her) levels that were needed in intensive care (who looked after her and her diabetes wonderfully). She was very frail and could not even do her own injections. Not surprisingly, the first night in the ward she had a series of bad hypos, which the ward sisters semi ignored - she had hallucinated while in intensive care because of her illness. The next day (Saturday) she knew her insulin doses needed to be lowered but the ward sister was unable to find a diabetic specialist to authorise this and her only option was to refuse either her basal or bolus insulin. She opted to refuse the bolus, because she was too weak to quickly eat the large quantities that would have been required if she'd taken it. Though that of course meant that she was now committed to 24 hours more of excess basal.

24 hours later the diabetic specialist was extremely apologetic as he told the nurses to allow her any quantity of insulin she asked for....
According to my mother, and my observations agreed, the ward was very understaffed (piteous calls for help from patients who'd wet their beds in adjacent room), some patients had call buttons that did not work, and she found the night nurse's treatment of the dementia lady with a broken bone (hip?) opposite her to be borderline sadistic (obviously I did not see this because it was at night). The nurses had very little clue about T1, though they did their best.

I fear ever being stuck in a hospital at under 100% mental capacity or too frail to do my own injections....

And back to the original issue, surely with a blood sugar in the 1s she should have gone onto a glucose drip? I don't understand why they could not call a doctor, but suspect the fact that it was a weekend had something to do with it.

And on a more cheerful note, @mouseee , that is one adorable avatar.

The nurse who was initially alerted should, in my opinion, quickly see and assess your mother re conscious level, whether she could swallow on instruction. Having determined she was not conscious, she should have immediately called the doctor as an emergency call.

As already mentioned, I would have thought some emergency hypo kit would be readily available and a member of staff who knew how to use it properly.

I do hope your Mum is OK and that they monitor her better as a result of this incident. {{{Hugs}}} to you

My experiences, both myself and t1 & t2 friends, recently indicate that most medical staff seem to be confused about current advice and treatment.
And my local hospital doesn't provide low carb meals.

mouseee said:

What do I say to the nurses tomorrow to make sure she has the care she needs for her diabetes?

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A similar thing happened to my father. His problem was that at home he was eating chocolate all the time along with muesli, toast and honey (because it's healthy). In hospital there were not the treats but the same amount of insulin. It was several days before they reduced the insulin which of course had to be increased as soon as he got home.

My own experience in hospital is that nursing staff seem to be a little lacking in knowledge. I wouldn't blame them, I guess it's considered to be a specialist subject.

mouseee said:

I think they should be monitoring her more closely for bs tonight and tomorrow at the least.

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I've often thought that for £50 (£35 to the NHS), the price of a Freestyle Libre Sensor, they could monitor someone for two weeks, and with the new sensors, now long overdue, they could have warnings as well. The savings in nurse's time would be enormous (sorry if that's over exaggerating). The savings would certainly be more than the £35 paid for each sensor.

All I would say in addition to the great replies above, is ALWAYS speak to the Ward staff and any Consultant or Doctor you can get your hands on at the hospital, even if it means waiting to see them. Double check the records as well, even those that are kept around the Nurses station, not just the ones at the end of the bed. I have had 40 years of these experiences (with my type 1 Mum) and believe me when I say there have been numerous mistakes made which nearly finished her off. Don't be fobbed off by any medical staff, be pleasant, well informed and above all proactive in your Mum's care. We would drop in unexpectedly at meal times regardless of their protected status because we KNEW nobody would ensure my Mum so much as ate her meal or even whether she would have had her injection on time. I am not having a go at Nurses by the way, mostly they were a lovely bunch of people but they simply did not know how to treat a patient with diabetes on a ward for another condition.

DavidGrahamJones said:

A similar thing happened to my father. His problem was that at home he was eating chocolate all the time along with muesli, toast and honey (because it's healthy). In hospital there were not the treats but the same amount of insulin. It was several days before they reduced the insulin which of course had to be increased as soon as he got home.

My own experience in hospital is that nursing staff seem to be a little lacking in knowledge. I wouldn't blame them, I guess it's considered to be a specialist subject.



I've often thought that for £50 (£35 to the NHS), the price of a Freestyle Libre Sensor, they could monitor someone for two weeks, and with the new sensors, now long overdue, they could have warnings as well. The savings in nurse's time would be enormous (sorry if that's over exaggerating). The savings would certainly be more than the £35 paid for each sensor.

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Hi David, 'a little lacking in knowledge' is an understatement, most did not have a clue how it worked, they simply think insulin followed by a meal, timings, what's that?, amount of carbs, eh?, insulin before or after, erm, not sure!!! and on and on.

KK123 said:

'a little lacking in knowledge' is an understatement,

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Only referring to my experience. I can see your experience is different.

If you are able to still handle it, always insist on keeping your insulin yourself in hospital and doing your own injections. Don't allow nurses to lock it away. Let the staff test you as often as they like but always do your own insulin if you are in a suitable state.

EllieM said:

I fear ever being stuck in a hospital at under 100% mental capacity or too frail to do my own injections....

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So do I !

mouseee said:

I have no idea how I would cope in hospital as the menu is impossible to eat LC from. My bs would go up to a point I don't even want to think about.

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I suspect you'd rely on food brought in by friends or family members....