![]() The HCW was defined as the person to whom the task of administering insulin was delegated, either a non-regulated role (e.g. This included ongoing assessment and supervision of practice. The Registered Nurse was defined as accountable for the delegation of any aspects of the task and ensuring the individual was competent to carry it out, in line with Item 11 of the Nursing and Midwifery Council (NMC, 2018) Code. Scope and accountabilities were clearly defined within the guideline, specifying the duties and responsibilities of the HCW’s employer, the Head of Community Nursing, the Registered Nurse responsible for delegating the task and the HCW, in line with recommendations from the NHSE/NHSI voluntary framework. The outcomes of the pilot and subsequent development of the guideline gave key stakeholders assurance that investing in the wider roll-out of insulin delegation was safe for patients, had the necessary clinical governance and was worthwhile in terms of net efficacy savings. Prior to the launch of the NHSE and NHSI framework, joint working led by East Sussex Healthcare NHS Trust with Sussex Community NHS Foundation Trust resulted in the drafting of a guideline to build upon a successful pilot of insulin delegation in care homes and District Nursing, which had been carried out in October 2019 and covered the delegation to appropriately trained HCWs in residential/care homes of insulin administration using pens to adult persons with diabetes in the community who have either type 1 or type 2 diabetes. NHS England and NHS Improvement (NHSE and NHSI, 2020) published a voluntary framework for teaching and training HCWs to administer insulin to adults with type 2 diabetes who are unable to perform this task themselves and have no family or unpaid carer who can do it for them. To manage this demand, appropriately trained and competency-assessed health and care workers (HCWs), including health support workers and healthcare assistants, have been identified as capable to perform the delegated task of insulin administration to those people with diabetes whose glycaemic control is stable. This has resulted in additional pressure on already overstretched District Nursing workloads, especially on the background of the COVID-19 pandemic. The number of older, frail, and comorbid people with diabetes requiring insulin therapy is also increasing, and many are reliant on community services for the provision of this crucial intervention. ![]() All adults with type 1 diabetes and some with type 2 diabetes are reliant on insulin treatment to manage their condition. By systematizing available data on such devices and present regulations in CPL issuance worldwide, our review can be used as handy tool for a fruitful discussion among the scientific community, national and international civil aviation regulators, stakeholders and pilots, aimed at evaluating the evidence-based opportunity to revise CPL issuance criteria for insulin-treated diabetic pilots.įor the above-mentioned reasons, there are, among the regulatory administrations of Civil Aviation around the globe, several different approaches and limitations set for the subjects with insulin-treated diabetes who want to obtain, or renew, a CPL.More than 4.9 million people in the UK have diabetes (Diabetes UK, 2021). CGM clearly showed to prevent hypoglycemic events in insulin-treated diabetic patients by allowing strict monitoring and trend prediction of glucose levels. It could be possible now to revise this attitude thanks to the availability of Continuous Glucose Monitoring (CGM) devices. ![]() This negatively affects social and working aspects of pilots’ lives, who have a high profile and a high-cost professional qualification. This depends on justified concerns about hypoglycemia, the most threatening event for people who carry out jobs requiring a high level of concentration and reliability. Civil aviation pilots who develop insulin-treated diabetes and want to renew a Commercial Pilot License (CPL) represent a medical, social and regulatory problem.
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