When questioned as part of the routine risk assessment by the custody sergeant, when prisoners are bought to a police station, some may then falsely declare themselves to be ill or on medication for chronic illnesses. This results in a referral to either the custody nurse or the duty FME. The motives for these false allegations are varied, but the risks of giving such false information especially relating to type, dosage and frequency of medication are potentially fatal. In those who have declared themselves to be diabetic it has occasionally been felt that in retrospect not all of them were being truthful. A review has been done of the results over a 4-year period of those who had declared themselves to be diabetic and agreed to have a blood test done. This has shown that 65% have a blood sugar level in the normal range on initial testing. The importance of repeated blood sugars during their detention is stressed for monitoring and as part of the handover to the next clinician. It is vital that these results be logged in the official custody record for later reference. Incidents have occurred when diabetics have pretended to inject their insulin in the misguided anticipation of a transfer to hospital when they become ill. All dosages of insulin should be double checked and self administration by the patient very carefully observed. The treatment of hypoglycemia using easily available and measured sugar portions from high street coffee shops is also discussed from a practical and common sense approach that is so often required in custodial medicine.
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