Treating Diabetes in Custody

PIONEERING work by NHS Lothian to ensure that people with diabetes in police custody receive suitable care has reduced the number of emergency referrals of prisoners to hospital.
A special one-day conference has been arranged to enable healthcare professionals working in a custody environment, and police from across Scotland and northern England, to learn from the Edinburgh experience.
Police officers face a tough challenge distinguishing between the effects of alcohol or drugs and the symptoms of potentially life-threatening conditions that can be caused by sudden changes in blood sugar levels.
This can be made more difficult when a prisoner has been taking drugs or alcohol, so that the metabolic problem is either masked or not identified.
Missing the signs of low blood sugar (a “hypo”) could allow a person to fall into a coma or could even be fatal.
A joint initiative between NHS Lothian and Lothian and Borders Police has established a new approach that has helped custody officers to swiftly identify and treat problems related to diabetes.
Consultant physician, Professor Brian Frier and diabetes specialist nurse, Janet Barclay, have led the project at the Department of Diabetes at the Royal Infirmary of Edinburgh.
Janet said: “We have worked closely with Edinburgh police and the forensic nursing service to make sure that staff have had training and have equipment available to identify and help prisoners with diabetes-related problems.
“The results have been excellent both for the patients and the NHS.”
“One of the major benefits has been an average of five fewer emergency referrals a week to the Royal Infirmary of Edinburgh.
“This has meant staff at Scotland’s busiest A&E Department have had more time to attend to other patients and has also saved on the cost of emergency treatment.”
The project followed a request from Professor Anthony Busuttil, chief forensic medical examiner, to Prof Frier for help in improving diabetes management in detainees at Edinburgh’s central custody suite at St Leonard’s Police Station.
Prof Frier said: “I think the model we have developed in Edinburgh is one that other police forces might want to adopt and use locally.”
“The police have a difficult problem dealing with people who have diabetes and are being held in custody.
“Some are drunk or under the influence of drugs, and they may have other medical problems following a driving accident or an assault.
“It can be very difficult to identify diabetes-related problems such as low blood sugar, which may need urgent medical treatment.
“Some prisoners are uncooperative or violent and others may be unable to tell the police they have diabetes.
“The present project has increased the knowledge of officers about identifying and treating diabetic emergencies and how to look after diabetes for people in custody”.
“The staff at St Leonards have noticed that an increasing number of prisoners have some type of diabetes.
“This is likely to be the case elsewhere in Scotland as diabetes is becoming more common throughout the UK.”
Police estimate that the service improvements have brought savings of

Contact: Aileen Cowden
Phone: 0131 536 9315
Email: aileen.cowden@nhs.net
Website: http://www.nhslothian.scot.nhs.uk