How do I install the Es Cc Outpatient Preference skill?

Run npx skillmds@latest add dromlakhani/es-cc-outpatient-preference in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

Is Es Cc Outpatient Preference safe to use?

This skill has not completed SkillMD's automated safety review yet. Independent scanners report: SkillSpector: PASS, Skill Scanner: PASS. Capability flags: makes network calls. SkillMD never runs a skill's scripts for you; review the SKILL.md before installing.

Which AI agents work with Es Cc Outpatient Preference?

This skill is tagged as working with Claude Code, Claude.ai, OpenAI Codex. SKILL.md is an open format, so most agents that read a skills directory can load it too.

Is Es Cc Outpatient Preference free to use?

Yes. Installing skills from SkillMD is free, and the skill stays under its author's original license.

Who published Es Cc Outpatient Preference?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Es Cc Outpatient Preference by dromlakhani

Name: Es Cc Outpatient Preference
Rating: 4.5 (4 reviews)
Author: dromlakhani

Es Cc Outpatient Preference

This skill determines whether a patient performs carbohydrate counting in the outpatient setting, including insulin-treated type 2 diabetes, and may prefer to continue this method during hospitalization. Clinical triggers include questions such as "Patient uses carb counting at home, should we allow continuation in hospital?"

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Determine if patient performs carbohydrate counting in outpatient setting and may prefer to continue during hospitalization

STEP 1 — Gather Information

Collect diabetes type (T1D, T2D, noninsulin-treated T2D), outpatient carbohydrate counting use (yes/no), insulin treatment status, and hospital resources (CC policy, expertise, ability to adjust insulin-to-carbohydrate ratio); document findings.

STEP 2 — Rule In / Rule Out

If patient does NOT use carbohydrate counting in outpatient setting → Rule out continuation of CC; select alternative prandial insulin dosing per insulin status (noninsulin-treated T2D: follow Rec 9.1; insulin-treated T2D/T1D: follow Rec 9.2 with fixed dosing). If patient DOES use carbohydrate counting in outpatient setting → Proceed to step 3.

STEP 3 — Classify or Stratify

Classify patient as insulin-treated (T1D or insulin-treated T2D) or noninsulin-treated T2D based on outpatient insulin use.

STEP 4 — Decide

If patient uses CC outpatient AND is insulin-treated → Recommend continuation of CC during hospitalization with individualized ICR adjustments, provided hospital has CC policy and expertise. If patient uses CC outpatient but is noninsulin-treated T2D → Recommend against CC; use fixed prandial insulin dosing. If patient does not use CC outpatient → Follow recommendation per insulin status: noninsulin-treated T2D requiring prandial insulin: suggest not using CC (Rec 9.1); insulin-treated T2D/T1D: suggest either CC or fixed dosing (Rec 9.2).

Clinical Guardrails / Mimics / Pitfalls

Do not assume patient wants to continue CC without confirming outpatient use; do not implement CC without hospital policy and expertise; avoid CC in noninsulin-treated T2D per guideline; adjust ICR for illness-related insulin resistance; avoid CC if patient lacks capacity to self-manage due to cognitive/functional limitations.

Concrete Clinical Example

A 58-year-old with type 1 diabetes uses carbohydrate counting at home, admitted for pneumonia. Patient confirms outpatient CC use, insulin-treated. Hospital has diabetes educator and CC policy. Decision: Continue CC during hospitalization with ICR verification and adjustments for infection-related insulin resistance.

Source: Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2022, https://doi.org/10.1210/clinem/dgac278

---name: es-cc-outpatient-preferencedescription: This skill determines whether a patient performs carbohydrate counting in the outpatient setting, including insulin-treated type 2 diabetes, and may prefer to continue this method during hospitalization. Clinical triggers include questions such as "Patient uses carb counting at home, should we allow continuation in hospital?"---# Determine if patient performs carbohydrate counting in outpatient setting and may prefer to continue during hospitalization## STEP 1 — Gather InformationCollect diabetes type (T1D, T2D, noninsulin-treated T2D), outpatient carbohydrate counting use (yes/no), insulin treatment status, and hospital resources (CC policy, expertise, ability to adjust insulin-to-carbohydrate ratio); document findings.## STEP 2 — Rule In / Rule OutIf patient does NOT use carbohydrate counting in outpatient setting → Rule out continuation of CC; select alternative prandial insulin dosing per insulin status (noninsulin-treated T2D: follow Rec 9.1; insulin-treated T2D/T1D: follow Rec 9.2 with fixed dosing). If patient DOES use carbohydrate counting in outpatient setting → Proceed to step 3.## STEP 3 — Classify or StratifyClassify patient as insulin-treated (T1D or insulin-treated T2D) or noninsulin-treated T2D based on outpatient insulin use.## STEP 4 — DecideIf patient uses CC outpatient AND is insulin-treated → Recommend continuation of CC during hospitalization with individualized ICR adjustments, provided hospital has CC policy and expertise. If patient uses CC outpatient but is noninsulin-treated T2D → Recommend against CC; use fixed prandial insulin dosing. If patient does not use CC outpatient → Follow recommendation per insulin status: noninsulin-treated T2D requiring prandial insulin: suggest not using CC (Rec 9.1); insulin-treated T2D/T1D: suggest either CC or fixed dosing (Rec 9.2).## Clinical Guardrails / Mimics / PitfallsDo not assume patient wants to continue CC without confirming outpatient use; do not implement CC without hospital policy and expertise; avoid CC in noninsulin-treated T2D per guideline; adjust ICR for illness-related insulin resistance; avoid CC if patient lacks capacity to self-manage due to cognitive/functional limitations.## Concrete Clinical ExampleA 58-year-old with type 1 diabetes uses carbohydrate counting at home, admitted for pneumonia. Patient confirms outpatient CC use, insulin-treated. Hospital has diabetes educator and CC policy. Decision: Continue CC during hospitalization with ICR verification and adjustments for infection-related insulin resistance.**Source:** Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2022, https://doi.org/10.1210/clinem/dgac278

Frequently asked questions