“The wish for healing has ever been the half of health.”
–Seneca the Younger
Most people experience a stay in the hospital at least once in their lives, and for some, it is much more often than that. No matter what the reason for your admission to the hospital, it is imperative that your blood glucose levels be controlled while you are there.
More and more research shows that maintaining optimal blood glucose control in the hospital improves a person’s chances of having the best possible medical outcome. However, achieving optimal control in the hospital is a challenge. Stress tends to raise blood glucose level, and in the hospital, the stresses are many: Illness itself is a physical stress, as are pain, surgery, and other medical procedures such as having blood drawn for tests. Simply being in the hospital is a physical and mental stress with all of the changes in routine. And worrying about the reason you’re in the hospital, whether your diabetes is being controlled properly, how much the hospitalization is going to cost you, how your family or job is making out without you, etc., simply adds to it.
If your hospital admission is not an emergency, you and your health-care provider have more time to prepare so that some of the stress of being in the hospital can be minimized. For example, you can establish ahead of time whether your personal physician will be overseeing your care while you’re in the hospital or, if not, who will. You can also discuss how your diabetes will be controlled and whether and when to stop taking any medicines you may currently take. And you can make plans for dealing with such personal responsibilities as child care or pet care during your hospital stay.
If you are admitted to the hospital through the emergency room, it is standard practice for the hospital to try to notify your primary-care physician. If your primary-care physician has privileges to practice in that particular hospital, he may come to see you there. If not, you will be treated by a physician on the hospital staff. Once you are released, it’s a good idea to follow up with your personal physician and make him aware of your recent hospitalization.
Your hospital diabetes plan
Whether your hospital stay is a scheduled trip recommended by your health-care provider or the result of an illness or injury, treating your diabetes is an essential part of your hospital care. Components of that care should include the following:
- Your diagnosis of diabetes should be clearly noted in your medical record. When you speak with hospital staff members, double-check to make sure they are aware of your diabetes, including which type of diabetes you have, your current level of blood glucose control, and any diabetes-related complications you may have.
- Your care should include routine blood glucose monitoring by trained hospital personnel, with results noted in your hospital record and available to all members of the health-care team.
- Insulin doses given to cover your meals should be appropriately timed and adjusted according to the results of the blood glucose monitoring performed by hospital personnel.
- When necessary, supplemental, or “correction,” doses of insulin should be given along with your premeal insulin to lower high blood glucose levels.
- Your physician should monitor your need for correction doses and consider how often you typically need them when making adjustments to your overall hospital insulin regimen.
- If you receive any therapies that will likely worsen your blood glucose control, such as high-dose glucocorticoids (steroid-type drugs), adjustments to your insulin doses should be made based on your blood glucose levels.
- Typically, hospitals have guidelines for treating hypoglycemia (low blood glucose), which may be different from those you normally use to treat yourself. If you develop hypoglycemia during your hospital stay, you should be treated promptly, and the episode should be noted in your medical record.