8.0.0.0 SELF-‍MAN­AGE­MENT IN THE HOS­PI­TAL

Di­a­betes self-‍man­age­ment in the hos­pi­tal may be ap­pro­pri­ate for se­lect youth and adult pa­tients (61,62). Can­di­dates in­clude pa­tients who suc­cess­ful­ly con­duct self-‍man­age­ment of di­a­betes at home, have the cog­ni­tive and phys­i­cal skills need­ed to suc­cess­ful­ly self-‍ad­min­is­ter in­sulin, and per­form self-‍mon­i­tor­ing of blood glu­cose. In ad­di­tion, they should have ad­e­quate oral in­take, be proficient in car­bo­hy­drate es­ti­ma­tion, use mul­ti­ple daily in­sulin in­jec­tions or con­tin­u­ous sub­cu­ta­neous in­sulin in­fu­sion (CSII), have sta­ble in­sulin re­quirements, and un­der­stand sick-‍day man­age­ment. If self-‍man­age­ment is to be used, a pro­to­col should in­clude a re­quirement that the pa­tient, nurs­ing staff, and physi­cian agree that pa­tient self-‍man­age­ment is ap­pro­pri­ate. If CSII is to be used, hos­pi­tal pol­i­cy and pro­ce­dures delineat­ing guide­lines for CSII ther­a­py, in­clud­ing the chang­ing of in­fu­sion sites, are ad­vised (63).