Contact Us

Delegation of Diabetes Tasks by a RN

When a licensed nurse is not available, an RN, who has met the requirements listed in ARSD 20:48:04.01:17, may delegate diabetes tasks to a nursing assistant, including the administration of subcutaneous (SQ) insulin.  

Delegated tasks may include:

  • Helping a person with an insulin pump or with an insulin pen device;

  • Administering SQ insulin from a vial and syringe or with an insulin pen device;  

  • Assisting a person with counting carbohydrates; 

  • Performing blood glucose monitoring.

Nurses are required to follow rules on: 

Nurses and employers are encouraged to use the Delegation Decision Making Algorithm to guide whether a specific nursing task may be delegated.

Prior to an RN Delegating Tasks

A Nursing Assistant must:

  • Complete the 10-hour diabetes aide training course taught by an RN instructor, as described below;  

  • Pass a final exam, administered by the RN instructor;

  • Pass a skills competency checklist.

A Delegating RN must:

  • Have on file a written protocol that includes the requirements listed in ARSD 20:48:04.01:16;

  • Complete the BON's online RN Train-the-Trainer Course;

  • Teach or ensure that the 10-hour diabetes aide training course has been completed by the Nursing Assistant.  The 10-hour course must consist of: 

    • 5-hours of theoretical instruction on the diabetes topics listed in ARSD 20:48:04.01:16(1)

    • 5-hours of clinical/lab instruction that includes an evaluation of the Nursing Assistant's competency to perform the diabetes tasks using the Board's approved Diabetes Aide Competency Checklist;

    • The administration of a final exam. 

      • The RN instructor may contact the Board to request access to questions for use in developing a final exam.

  • Annually, revalidate the Diabetes Aide's competency using the Board's approved Diabetes Aide Competency Checklist.

Documentation of training should be maintained by the employer or RN. 


Diabetes aides employed in Assisted Living Centers are required to be registered as a Medication Aide.