I wrote something very strange in our patient's notes today...

Plan:
1) Scrambled eggs tds
2) Rice bubbles prn
3) Await dietitian review

Patient is a T1DM with hypoglycaemia unawareness. Due to prolonged periods of hypoglycaemia, this patient also has an acquired brain injury.

In hospital, this patient has refused to eat lunch at all and not much of breakfast or dinner. Not surprisingly, his BSLs are all over the place. After a bit of wheedling, my registrar finally found out he only drinks coffee, only eats rice bubbles for breakfast and only wants to eat scrambled eggs. So...my registrar went and bought a box of rice bubbles for him and told the kitchen to cook scrambled eggs for the patient three meals a day. Nothing else. I don't think the dietitian will have much luck convincing the patient that a varied diet will be more nutritious and better for his T1DM but oh well...

On another note, I have to say that nurses really should get some basic training in managing T1DM. My intern got two pages today saying, "Patient BSL 3.2, refusing food. Withhold insulin?" The only thing my intern said to me, "Yeah, sure! Withhold the insulin but make sure you call ED and tell them you're giving a patient DKA!"