Diabetes Self-Management Articles

These articles cover a wide range of subjects, from the most basic aspects of diabetes care to the nitty-gritty specifics.

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What to Expect in the Hospital

by Laura Hieronymus, MSEd, APRN, BC-ADM, CDE, and Susanna Robinson, RPh, CDE

If you are scheduled for surgery, you may need to follow a “full liquid” or “clear liquid” diet in preparation. The liquids served in place of solid food will contain carbohydrate and will not be sugar-free.

It’s also possible that you will need an alternative form of feeding such as the use of a feeding tube (called enteral feeding) or intravenous feeding (called parenteral feeding). In these cases, your physician, in consultation with the hospital dietitian, will decide on the desired formulation of nutrients.

Before you leave the hospital, a registered dietitian who is familiar with the effect of food choices on blood glucose levels in people with diabetes will usually advise you on eating at home. The registered dietitian is responsible for integrating information about your condition, your eating and lifestyle habits, and your treatment goals to come up with a realistic, individualized meal plan for you. The registered dietitian may also recommend that you return as an outpatient for further nutrition counseling after you leave the hospital.

Being your own advocate
Nobody knows your diabetes better than you do. If your hospital stay is a planned one, speak to your physician and diabetes educator beforehand to find out the specifics of how your diabetes will be managed during your stay. Be sure and identify the physician who will be managing your diabetes, and make sure you understand the plan. (If you don’t, ask questions.)

In the event that you receive treatment in an emergency room or at an urgent care facility, it’s possible that you will know more about the latest technology for diabetes control than the people caring for you. Medical professionals who do not provide routine diabetes care, for example, may not be familiar with insulin pumps and how they work. If you use an insulin pump and are asked to remove it in one of these settings, you will need to communicate your urgent need for a physician’s order for an alternate method of insulin delivery to avoid developing high blood glucose.

Once admitted to the hospital, if you question any aspect of your inpatient diabetes treatment plan, ask for clarification. If you don’t feel able to speak up for yourself but do have a friend or family member who can do it for you, ask that person to speak with your caregivers in the hospital about your concerns.

With a physician’s order, a person with diabetes may be able to assist in managing his diabetes while in the hospital, as long as he is mentally competent and has a stable level of consciousness. A physician is also more likely to agree to self-management during the stay if a person has relatively stable insulin requirements and experience in managing his insulin doses and blood glucose monitoring at home. The patient and physician, in consultation with the hospital nursing staff, must agree that patient self-management is appropriate under the conditions of hospitalization and together must ensure that it is conducted according to hospital policy.

If you are managing your own diabetes in the hospital, all of your self-directed care should be reported to the nurse or other hospital staff member assigned to your care and documented by the staff member in your hospital record. Also, it is important to speak up if you don’t feel well enough to carry out your care or need assistance with your diabetes treatment plan at any time during your stay.

No matter what has put you in the hospital, diabetes management should always be a priority. Optimal blood glucose control during your stay may hasten your trip down the road to recovery.

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Also in this article:
Blood Glucose Goals in the Hospital
Diabetes Drugs in the Hospital



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Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.



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