An audit review of end-of-life care for inpatients with diabetes

The decision to withdraw capillary blood glucose (CBG) monitoring and glycaemic treatment at the end of life in people with diabetes may have implications for comfort-care management in the dying individual in the acute care setting. The paradigm shift to the self-management of diabetes through CBG monitoring enables patients or their relatives to contribute to decisions for the withdrawal of CBG monitoring or antidiabetes treatment. Although it is unknown whether glycaemic symptoms are perceived in dying persons in the same way as those in full health, there is still an obligation to consider their effects on comfort at the end of life. In this article, the authors report the findings from a medical-notes audit in which they evaluated some key assumptions about advocacy (self or other) for end-of-life care decisions and the management of diabetes.