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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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