The timing of insulin administration to hospital inpatients is unsafe: Patient self-administration may make it safer

It is routine practice for insulin to be administered by hospital staff to diabetic inpatients who would normally self-inject at home. The accuracy of this practice has not been clearly evaluated. Our audit aimed to evaluate the accuracy of insulin administration times, patient preference and the possibility of self-administration by hospitalised patients.

Information on patient preferences, and the timing of meals and insulin administration, was collected for insulin-treated diabetic inpatients whose insulin was administered by hospital staff (Group 1), and for another group whose insulin was self-administered (Group 2).

In Group 1 (175 meals, 25 patients), only 19% of insulin administration times were deemed accurate. In this Group, 15/21 patients wanted to self-inject in hospital. In Group 2 (10 patients, 73 meals), the timing of 57/73 (78%) insulin self-administrations was accurate, and the remaining errors were often not through patient fault.

The timing of insulin administration to hospitalised patients needs to be improved. An option may be to allow selected patients to self-administer their insulin.