Mervin Bint has been living with diabetes for 52 years. He was first diagnosed at the age of 9 and has been on insulin ever since.

Mervin Bint has already seen marked improvement in how health-care providers are helping him manage his blood glucose levels during his current stay at St. Paul’s Hospital.

He has managed his blood glucose levels by monitoring what he eats, with his activity levels and by taking insulin.

“It’s what you do,” says Bint, referring to his life with diabetes. But often, when patients with diabetes end up in hospital, the health-care system uses a different monitoring approach. That’s confusing and frustrating and is a far stretch from what would be considered patient-centred care.

“We are using a reactive way to manage blood sugars in hospital,” says Loretta MacDonald, Diabetes Nurse Educator with Chronic Disease Management at Humboldt District Hospital. “The blood sugar has to rise before we give a dose of insulin to bring it down. This is called a ‘sliding scale’ insulin management strategy.”

That strategy is changing. And during November, Diabetes Awareness Month, it’s a positive message for patients who have insulin dependent diabetes.

“We will use a proactive approach, using basal, prandial concepts to prevent blood sugars from rising in the first place,” says MacDonald. “This is a physiologic way of managing diabetes by using methods that mimic how the body naturally produces insulin, and what our clients do at home.”

Why do we need to do things differently?

“That’s a good question,” says MacDonald. “There are many reasons why people may have higher blood sugars when they are in hospital. At one time in my career ‘sliding scale’ was a welcome method of bringing down the blood sugars.” She adds, “On the other side of the coin, we also are very concerned about blood sugars that can go too low. We will still be using a type of scale but the concepts are different. There is a lot of evidence showing why we need to change our practice to improve our care and keep our patients safe.”

MacDonald has been part of the Saskatoon Health Region Insulin Task Force which, since last November, has been developing a system that meets the needs of health-care professionals and patients. The task force has developed early-messaging posters, held education sessions for nurses and physicians and developed an e-learning program for continued learning.

Mervin Bint has already noticed a difference in his current hospital stay compared to other times. “They’re more thorough about the dietitian coming to visit me, and the doctor who’s a specialist in insulin and blood sugar levels has been in to see me. It’s progress,” he says.

Visit InfoNet for more information on the work of the Regional Insulin Task Force.