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Diabetes Management in Correctional Institutions

Abbreviations: CBG, capillary blood glucose • DKA, diabetic ketoacidosis • GDM, gestational diabetes mellitus • MNT, medical nutrition therapy

The first 300 words of the full text of this article appear below.

	INTRODUCTION

 
At any given time, over 2 million people are incarcerated in prisons and jails in the U.S (1). It is estimated that nearly 80,000 of these inmates have diabetes, a prevalence of 4.8% (2). In addition, many more people pass through the corrections system in a given year. In 1998 alone, over 11 million people were released from prison to the community (1). The current estimated prevalence of diabetes in correctional institutions is somewhat lower than the overall U.S. prevalence of diabetes, perhaps because the incarcerated population is younger than the general population. The prevalence of diabetes and its related comorbidities and complications, however, will continue to increase in the prison population as current sentencing guidelines continue to increase the number of aging prisoners and the incidence of diabetes in young people continues to increase.

People with diabetes in correctional facilities should receive care that meets national standards. Correctional institutions have unique circumstances that need to be considered so that all standards of care may be achieved (3). Correctional institutions should have written policies and procedures for the management of diabetes and for training of medical and correctional staff in diabetes care practices. These policies must take into consideration issues such as security needs, transfer from one facility to another, and access to medical personnel and equipment, so that all appropriate levels of care are provided. Ideally, these policies should encourage or at least allow patients to self-manage their diabetes. Ultimately, diabetes management is dependent upon having access to needed medical personnel and equipment. Ongoing diabetes therapy is important in order to reduce the risk of later complications, including cardiovascular events, visual loss, renal failure, and amputation. Early identification and intervention for people with diabetes is also likely to reduce short-term risks . . . [Full Text of this Article]

	INTAKE MEDICAL ASSESSMENT

 
Reception screening
Intake screening
Intake physical examination and laboratory
Recommendations

	SCREENING FOR DIABETES

 

	MANAGEMENT PLAN

 

	NUTRITION AND FOOD SERVICES

 

	URGENT AND EMERGENCY ISSUES

 
Hyperglycemia
Hypoglycemia
Recommendations

	MEDICATION

 
Recommendations

	ROUTINE SCREENING FOR AND MANAGEMENT OF DIABETES COMPLICATIONS

 

	MONITORING/TESTS OF GLYCEMIA

 
Recommendations

	SELF-MANAGEMENT EDUCATION

 

	STAFF EDUCATION

 
Recommendations

	ALCOHOL AND DRUGS

 

	TRANSFER AND DISCHARGE

 

	RECOMMENDATIONS

 

	SHARING OF MEDICAL INFORMATION AND RECORDS

 

	CHILDREN AND ADOLESCENTS WITH DIABETES

 
Nutrition and activity
Medical management and follow-up

	PREGNANCY

 

	SUMMARY AND KEY POINTS

 

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This article has been cited by other articles:

				S. McLaughlin Meeting the Challenges: Diabetes Care in Special Settings Diabetes Spectr, July 1, 2005; 18(3): 143 - 145. [Full Text] [PDF]

				L. L. Edwards Managing Diabetes in Correctional Facilities Diabetes Spectr, July 1, 2005; 18(3): 146 - 151. [Abstract] [Full Text] [PDF]

				American Diabetes Association Standards of Medical Care in Diabetes Diabetes Care, January 1, 2005; 28(suppl_1): S4 - S36. [Full Text] [PDF]