Managing your own insulin in hospital

This information aims to answer your questions about giving your own insulin while in hospital. It explains the benefits, risks and other options, and what you can expect when you come to hospital.

If you have any other questions, please speak to a doctor, nurse or pharmacist caring for you.

Usually when you come into hospital, a nurse gives your medicines to you. If you have diabetes, this may include the nurse injecting the amounts (doses) of your usual insulin. But we recognise that you might prefer to manage your own insulin using injections or through an insulin pump.

Deciding if you can manage your own insulin

Your nurse needs to assess if it is safe and in your best interests to give your own insulin injections. It might not be possible to manage your own insulin at this time if:

• you are very unwell
• we have made changes to your treatment that can affect your blood sugar (glucose)

In this case, a nurse gives you your insulin.

During the assessment, the nurse needs to ask you some questions. These questions check your understanding of insulin, including your doses and injection timings.

The nurse also checks your injection technique and that you can dispose of used insulin needles yourself in a yellow sharps bin.

Benefits of injecting insulin yourself

We recognise that people with diabetes are usually very knowledgeable about their condition and treatment. Often, you know better than anybody how your blood sugar level responds to different situations and different insulin doses.

Letting people with diabetes inject their own insulin in hospitals has been shown to:

• improve the timing of insulin doses
• give better blood sugar control
• help individuals to manage their insulin at home after they leave hospital

Risks of injecting insulin yourself

Insulin can be dangerous if you give yourself a wrong dose or have a dose at the wrong time. This is why we need to make sure that you are well enough to give yourself insulin. 

Sometimes, being unwell can affect how you make decisions. The nurse assesses your decision-making before they let you manage your own insulin.

Other medicines, such as steroids, can affect your blood sugar level. If you need these medicines, it may not be safe for you to give your usual insulin doses.

It is also important that you can immediately dispose of any used needles in a yellow sharps bin. For the safety of other patients on the ward, you need to store your insulin in a locked medicines cupboard.

Other options for your insulin treatment

You do not have to give your own insulin while you are in hospital. If you prefer, the nurses can manage your insulin injections. This does not affect the treatment that you get in any way.

Procedure for managing your own insulin

If you have any questions about giving your own insulin in hospital, please ask your nurse. They ask you to sign a consent form if you want to manage your insulin and this is safe.

You then have access to your insulin and can take it as you would at home. If you become too unwell to manage your diabetes, the nurses take over until you recover.

Here are some tips to manage your insulin safely in hospital.

Your insulin is stored in your bedside medicines locker, which is kept locked. If possible, we give you an individual key to get your insulin. But if an individual key is not available, ask the nurse to open the locker shortly before your insulin injection is due.

It is important that medicines are stored safely at all times and not left on the hospital ward. When you have done your injection, please ask a nurse to lock away the insulin again for you.

Changing your decision to manage your own insulin

You decide if you want to manage your own insulin in hospital. You can change your decision at any time, even if you have already signed the consent form. 

Please tell staff immediately if you change your decision about managing your own insulin treatment. We respect your wishes at all times.

If you would like to read our consent policy, please ask a member of staff.

Checking your own sugar levels

We check your blood sugar levels using our hospital blood glucose meters. These machines are precise and not affected by other medicines that we might give you during your stay.

The hospital blood glucose meters connect to our computer system for recording your medical notes and the medicines that we prescribe. We then have your blood sugar readings available when planning your treatment. This helps us to give you the best possible care.

There is no need to check your sugar levels with your own meter, continuous glucose monitor or flash monitor. But it is fine if you want to do this in addition to the tests with the hospital blood glucose meters.

Please tell a nurse if your sugar level is less than 4mmol/L or higher than 11mmol/L. They confirm the result with a hospital blood glucose meter and treat you if needed.

Symptoms of hypoglycaemia (hypos)

A low blood sugar level is called hypoglycaemia or a hypo. This is the main side effect of insulin treatment. You have a hypo if your blood sugar level drops below 4mmol/L.

A hypo can be dangerous if you do not treat it quickly. Snacks should be available on your hospital ward. You can ask the nurses or catering staff for a snack to prevent your blood sugar level from dropping too low.

Signs of a hypo include:

• sweating heavily
• feeling tired suddenly or having trouble concentrating
• dizziness
• feeling anxious or irritable
• trembling or shaking
• tingling lips
• feeling hungry
• going pale
• feeling uncomfortably warm
• a fast, pounding or racing heartbeat (palpitations)
• confusion
• difficulty speaking

If you have any of these symptoms, please tell your nurse immediately.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment.

If you want to manage your insulin and your nurse feels that this is safe, they ask you to sign a consent form. This says that you agree to give yourself insulin in hospital and understand what it involves.

It is important to read the information on this page and ask your nurse any questions before signing the consent form.

If you would like more information about our consent process, please speak to a member of staff caring for you.