Managing diabetes in the last days of life

Type 2 diabetic diet or Metformin Controlled – consider stopping metformin to reduce tablet burden.

Type 2 diabetic on other tablets, GLP1 injections and insulin – consider stopping tablets and GLP1 injections. Review insulin doses and consider stopping insulin if only small amounts are required.

• If a patient is hypoglycaemic, reduce insulin dose by 20%.
• If a patient is hyperglycaemic, increase by 10% if patient hyperglycaemic.

Type 2 Diet or Metformin controlled – If previously well controlled, blood glucose monitoring can cease.

Type 2 previous other tablets/ GLP1 injections or insulin

• If a patient remains on insulin monitor the same as type 1 diabetic (see above)
• If stopped insulin – can use urinalysis to monitor urine glucose, and if >2+, take a blood glucose reading