Diabetic care in corrections.

[coastalcattery]

I work in a fairly small town county jail. The provider and I don't see quite eye to eye on our policies for diabetics. What I would like to know is how are other facilities managing diabetics, specifically:

1. Does your facility go with carb control or calorie control diet for the diabetic inmate?

2. Are the food items that inmates can buy from the commissary restricted?

[AltaEnfermera]

Slightly different situation, (I worked in a large private/BOP facility), but I used to argue about this issue too. Our inmates were not restricted in any way, diet wise. According to policy, diet was dependent on the individual i/m to make healthy choices; they could choose from mainline meal or "heart healthy", which just meant slightly less fat. Problem is, there really weren't any options for diabetics offered. The only i/ms who had access to fresh fruits/veggies on a regular basis were those on "common fare", i.e. religious diet restrictions. So, to answer your question, our inmates were expected to restrict themselves in a sense, because there were no policies in place to ensure that they did. Which I agree with because they're adults, but I do wish they had more options available to choose from :S

[Neats, BSN]

i work at a state prison and am a director of nursing.

our state diabetic offenders can pick a healthy diet, and can be provided a diabetic snack. they do have access to the commissary to buy what they want if they have monies. while i read the comments i must say this:

we approach special needs this way

diabetic classes:

diabetics are invited first. if there are any left over seats then it is first come first serve. we teach diabetic learning (different topics) each month for up to 30 offenders in a classroom. the sign in sheet does not go into the medical record, we do document the diabetic education we provide to each diagnosed diabetic in their medical record.

whatever your beliefs are when it comes to diabetics and their choices, incarcerated or not, it is their choice. we can only document their compliance and back it up with a1c's. i contact the food store and get a print out of the food they buy and speak to them about their choices with their food store print out in front of them. sometimes we go item by item. i only do this once. this is the benefit of working in the correctional environment. if you were to educate someone on the outside you do not have the luxury of finding out what they bought unless they brought receipts.

it is not my job to "babysit" my incarcerated patients in order to police their medical care. i provide necessary medical care that is evidenced based when they request and in emergency situations.

we try hard to provide sound medical care that is beneficial to our population. preventive and education medical services; is to me the direction of where we need to focus our services.

[coastalcattery]

Neats, well said. I agree with you 100%.

[Kooky Korky, BSN, RN]

OP, how does your facility do it that you would like to change?

[bymysoultosqueezeRN]

no restrictions at all, they do get an order for ada 2400 diet but the kitchen doesnt serve it. they buy whatever they want at the commissary. They get chronic care clinic every 3 months and if the HbgA1c is above 8 i believe they should be seen every month, but that isnt exactly working out that well either