Last Modified: 10:08pm 08/04/2021

24 hours to Day 3 and after care

Expectation: patient should be steadily recovering, beginning to eat and drink, biochemistry back to

Ensure that clinical and biochemical parameters are improving or have normalised.
o Continue IV fluids until eating and drinking normally
o Variable rate insulin if not eating and drinking
o Convert to appropriate subcutaneous regime when biochemically stable
o Encourage early mobilisation
o Daily urea and electrolytes
o Remove catheter when clinically appropriate

Assess for signs of fluid overload or cerebral oedema.

Assess for evidence of continuing sepsis.

Daily foot checks.

Continue LMWH until day of discharge (consider extended treatment in very high risk patients).

Ensure patient has been reviewed by diabetes team.

After care
Most patients should go home on subcutaneous insulin (the regime being determined by their
circumstances). For patients with previously undiagnosed diabetes or well controlled on oral agents,
switching from insulin to the appropriate oral hypoglycaemic agent should be considered after a period of stability (weeks or months).

Ensure patient has appropriate diabetes education prior to discharge and arrange follow-up by diabetes team.

JBDS Guidelines