Lantus - what's protocol here?

[ButtterflyLady]

Here is another guideline, which may be the most relevant one of the 3 I've posted. This "we dont count carbs in hospital" comment sounds fishy to me. They are messing up her insulin regime and taking dangerous risks with her health and life IMO.

https://www.diabetes.org.uk/About_u...ions/Inpatient-care-for-people-with-diabetes/

 

[Daibell]

Here is another guideline, which may be the most relevant one of the 3 I've posted. This "we dont count carbs in hospital" comment sounds fishy to me. They are messing up her insulin regime and taking dangerous risks with her health and life IMO.

https://www.diabetes.org.uk/About_u...ions/Inpatient-care-for-people-with-diabetes/

Yes, form various posts on this forum over the years a lot of hospital nurses know little about insulin. The use of the so-called sliding-scale routine is highly suspect, often unnecessary and badly managed with resulting hypos. At my (private) hospital op last year the sensible staff said they wouldn't use it and let me do my own insulin but they also measured blood sugar when they wanted to. It's obviously difficult if you daughter doesn't manage her own insulin. Carb-counting with Basal/Bolus is virtually essential to avoid large sugar swings up and down.

 

[mirror]

She did use to manage her insulin
She's had a brain injury and can't use numbers

 

[mirror]

It gets worse
Just heard that they had to canulate through her shin into the bone marrow - it must have been bad! That really upsets me

 

[azure]

Sorry to hear that about your daughter, @mirror

Wishing her and you all the best.

 

[ButtterflyLady]

It gets worse
Just heard that they had to canulate through her shin into the bone marrow - it must have been bad! That really upsets me

Oh, that's awful, my heart goes out to her, and to you. I know how hard it is to have a loved one in hospital and you know there are things going on that aren't right, but you can't be there 24/7, and even when you are there, the staff don't really listen to you. I think especially since your daughter has a brain injury, there needs to be better communication between the staff and you/her. Do you have people supporting you as well? Hugs.

 

[mirror]

Quick update
Daughter luckily is physically fine.
On checking out the notes she was given 30 units in the morning (usually 32 at night which did need reducing)and then 32 units at night!
We are lucky she wasn't found dead in our opinion and are really considering taking things further. We wrote to the chief executive.

 

[TooMuchGlucose]

Quick update
Daughter luckily is physically fine.
On checking out the notes she was given 30 units in the morning (usually 32 at night which did need reducing)and then 32 units at night!
We are lucky she wasn't found dead in our opinion and are really considering taking things further. We wrote to the chief executive.

I'm glad she is doing better. You should definitely consider some legal action as you're right in saying she could have died. The hospital have acted with gross negligence. I'm pretty angry and in disbelief myself I can only imagine how you feel. I hope nothing like this happens again.

 

[tim2000s]

I think you need to get in touch with diabetes UK advocacy services. The hospital has clearly not met its duty of care requirements and in my opinion, legal action should be taken against them with the backing of Diabetes UK as they are clearly putting your daughter at risk.

 

[mirror]

Interesting Tim never heard of them
Will look at all this after we manage to get her out

 

[Spiker]

If she is in a brain injury unit or other non diabetic unit you need to get the diabetes unit in the hospital involved in jointly managing her care. General nurses etc rarely have a clue about diabetes management. This situation being conclusive proof as with a double dose, 30 unit overdose of Lantus and with minimal BG testing she could indeed have died. :-(

You can discharge her immediately at any time (assuming you have responsibility for her) but I am guessing she is in hospital for a reason so you need the support of that unit she is in? If not, just take her home. If she needs to stay in that unit for medical reasons then get the diabetic unit involved in her care or if possible have her moved to the diabetic ward and continue her treatment on that ward.

 

[ButtterflyLady]

I agree with the others, when I read how low her BG was when she collapsed, I was astonished at how close she came to seizures and death and my mind turned immediately to formal complaints and legal action (once she is safe at home).

Their negligence is breathtaking. Hang in there and keep taking good care of yourselves too.

 

[mirror]

Thanks
Luckily she has a discharge meeting anyway today for discharge tomorrow
She is in a rehab unit for brain injury attached to the hospital. She is under the dn of the hospital shockingly.
She had been deemed to lack capacity and has (runs out on Friday) a dols in place so we can't discharge (also need formal discharge planning for all the support etc at home)
There is going to be legal action looked at when she's out
Going to try a route via diabetes UK.

 

[ButtterflyLady]

Hi, I'm not sure what a dols is, but there may be a legal way to apply to the court for some sort of welfare guardianship that would allow you to be able to make any decision that she would have normally been able to make for herself, such as hospital discharge if desired. These sorts of things cost money but they might make things easier if needed in the future.

Glad she is hopefully getting discharged tomorrow, and that she is doing better. Hugs.

 

[slip]

WOW - Can I just clear this up a bit, so your daughter normally has 32u of Lantus (at night) but for one night it wasn't given, so they followed it up the next morning with 30u, and then gave her 32u that night and then found her collapsed with BS of 0.9?!

If so that is totally.......well I'm speechless.....and this was in a NHS hospital........?! God help us all.

I do wish you and your daughter all the best, I hope she gets out soon and recovers as much as possible.

 

[mirror]

Thanks

 

[mirror]

Diabetes UK don't offer legal advocacy

 

[mirror]

Just looking at the risk assessment for discharge
They say episodes of hypoglycaemia (during the whole stay) due to non compliance with eating and wanting to eat not at regular intervals What twaddle. If the lantus was correct. surely it would not matter if she ate or not?

 

[Spiker]

Just looking at the risk assessment for discharge
They say episodes of hypoglycaemia (during the whole stay) due to non compliance with eating and wanting to eat not at regular intervals What twaddle. If the lantus was correct. surely it would not matter if she ate or not?

Correct. They either don't understand basal-bolus or don't understand she was on basal-bolus.

 

[Spiker]

Diabetes UK don't offer legal advocacy

Then maybe you need a medical malpractice lawyer? Always an uphill struggle against the NHS particularly as, luckily, no actual harm was caused.

Typical of DUK not to want to rock the boat. I do wonder what use they are.