Diabetes at the Hospital: How to Be Your Own Advocate

It should be expected that you or your loved one be treated with the highest and safest level of care when you are in the hospital. But it is also part of your responsibility as a patient to understand your rights and to know what to expect if you are hospitalized for any reason. After all, you know your body best.

Be your own advocate. Or, if you are unable to advocate for yourself, and if the situation allows for it, have an advocate with you at least some point during your stay. This can be a family member or close friend who you feel comfortable with. Ask when your physician or other members of your health care team make their rounds so that your advocate is present with questions or concerns.

One of the things you should always do when preparing for a hospital stay is to carry a list of your current medications with your person. Your medications may be changed while you are in the hospital, and it is important to ask which meds were added or deleted so that you are clear what you are taking and why. This will also serve as a “double check” for your health care team at the hospital.  Most medications given in the hospital are listed by generic name instead of brand or “trade” names. For example, brand-name Glucophage will be known as Metformin in the hospital. If you have medication allergies, remind any new nurses or doctors of this fact. It should be in your chart, but in a busy hospital, things can get overlooked.

Patients don’t realize they are legally allowed to view their chart. Some hospitals try to push back on this and may say that you cannot see the chart until discharge, but you have rights as a patient. The HIPPA laws are in place to protect you; make sure you keep asking and know your rights!

When you know you’re going to be admitted to the hospital, it is crucial you are prepared to the best of your ability. A majority of patients with diabetes automatically get placed on a rapid acting insulin, like Apidra, based on blood sugar levels and nutritional intake. This happens even if you were on an oral antidiabetic medication such as glyburide at home. Depending on their length of stay, this may or may not be the best choice for particular individuals, but it is the most efficient means of keeping tight glucose control, especially during a time of illness or emotional stress, and remains protocol at most hospitals. Don’t get frightened by this: insulin usually starts at a low dose and is very closely monitored while you are in the hospital.

With increased staff shortages and higher patient ratios, low or high blood sugar side effects may not be immediately noticed in the hospital. If you feel sick or have a decrease in your level of consciousness due to other medical complications, an advocate may pick up on this first, especially if they know your baseline behaviors. The conscious and alert patient needs to know to inform the nurse right away if they feel the symptoms of low blood sugar such as dizziness, clammy cold skin or weakness.

For the patient that can eat, the nutritional services do their best to provide healthy, well-balanced meals and snacks. However, it is essentially the patients’ choice to utilize the best nutritional choices available. If you are given chocolate cake, for example, don’t just eat it because you assume it’s ok!

Illness, environmental and emotional stressors can all negatively impact glucose levels so it is important to be your own advocate of your own health and overall well being. Today, more than ever, we control or own outcomes to a large extent. Your health care team will appreciate your involvement. While in the hospital make sure you know the name of the doctor in charge of your case in case you need to contact him or her directly. Also, keep in mind that after a major medical event such as heart attack or surgery, you may need insulin upon discharge.  If you were not previously on insulin, you may not have to stay on insulin. As you heal, you may be able to be maintained on your oral medications.

Remember: Be sure to always count yourself as a member of your own healthcare team. Knowledge is power my friends. Stay well.

What are your experiences on managing your diabetes in a hospital? Share your thoughts on this article in the comment section below and check out this related discussion thread.