title: Management of diabetes in French prisons: a cross-sectional study.
abstract: OBJECTIVE
  To assess by a survey the management of prisoners with diabetes treated with insulin in French prisons.
  
  
  METHODS
  A questionnaire was sent to the head of healthcare services for prisoners of every French prison. Information was obtained on prevalence of insulin-treated diabetes prisoners and diabetes care in prison. The number of episides of ketoacidosis and hypoglycaemia needing hospital admissions were evaluated during the past year.
  
  
  RESULTS
  Among the 163 questionnaires sent, 115 were returned, giving an overall response rate of 69%. At the time of the study the prison population was 38 175 people. One hundred and sixty-nine prisoners were treated by insulin (0.4%). Self-monitoring of blood glucose was available only for 94 (55.6%) insulin-treated prisoners. A total of 130 (76.9%) prisoners performed two insulin injections daily or less, 105 (62.1%) prisoners were not allowed to keep their insulin delivery systems with them. Of the prisoners who treated themselves, 14 (12.1%) used syringes and 42 (36.5%) used pen devices. Ninety-two (55.1%) prisoners had had access to a diabetes specialist during the previous year. Diabetic diets were available in only 65 (60.7%) prisons. From June 1998 to June 1999, there were 20 hospital admissions for a diabetic ketoacidosis and 14 for hypoglycaemia.
  
  
  CONCLUSIONS
  This study shows that prison decreases the autonomy of diabetic prisoners who often cannot self-inject or test their blood. Access to visiting consultant diabetologists and specialist nurses to educate both prisoners with diabetes and prison staff could improve diabetic care.
authors.affiliation: Department of Diabetes and Endocrinology, Bocage Hospital, Dijon, France. jean-michel.petit@chu-dijon.fr
authors.forename: J M
authors.initials: JM
authors.lastname: Petit
authors.forename: M P
authors.initials: MP
authors.lastname: Guenfoudi
authors.forename: S
authors.initials: S
authors.lastname: Volatier
authors.forename: S
authors.initials: S
authors.lastname: Rudoni
authors.forename: G
authors.initials: G
authors.lastname: Vaillant
authors.forename: C
authors.initials: C
authors.lastname: Hermant
authors.forename: B
authors.initials: B
authors.lastname: Verges
authors.forename: J M
authors.initials: JM
authors.lastname: Brun
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D015190:Blood Glucose Self-Monitoring; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000628:therapy*; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000628:therapy; D016883:Diabetic Ketoacidosis / Q000453:epidemiology; D003927:Diet, Diabetic; D004496:Education, Continuing; D005602:France / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000032:analysis; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D010353:Patient Education as Topic; D015995:Prevalence; D011329:Prisoners; D011330:Prisons / Q000458:organization & administration; D011507:Proteinuria; D012648:Self Care; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin