Diabetes at the Hospital - What to do?

Keriann Strickland
By Keriann Strickland Latest Reply 2015-02-16 07:39:23 -0600
Started 2012-02-01 17:39:31 -0600

Susan shared this article with us about how to be your own advocate during a hospital stay: http://www.diabeticconnect.com/diabetes-artic....

What are your experiences with diabetes and hospital stays? What advice would you offer others?


48 replies

knutsoc
knutsoc 2012-03-05 18:57:15 -0600 Report

Following a motorcycle accident, I was admitted to a level 1 trauma hospital. Fortunately I was fully concious. I have worn an insulin pump for about 10 years. Imagine how I felt when I was informed I would have to remove it, and be put on a sliding scale. I was so upset I iinsisted on speaking with the head of the trauma team. I told him it did not make sense to take away a device that maintained tight control of my blood glucoses. I fought for myself, and signed a waiver to keep my pump. I had to agree to let them test as often as they wanted. It was no big deal really. I tested more frequently on my own anyway. I also had to agree that if my blood glucose went over 300, that I would allow them to give me an injection based on the sliding scale. Even following major back surgery to stabilize my fractured spine, I never needed the "extra help" from an injection. I spoke with the Director of Diabetes Education the second day I was in, and expressed my dissatisfaction with their policiy regarding insulin pumps. While I understand that not all paitents being admitted to a trauma unit are concious and aware of what is going on, their policy should have been a guildline, and not a standard protocol. I turned my admission into a teaching experience. I discovered that most staff nurses have no or little experience with an insulin pump. I took the time to show and tell each nurse that I crossed paths with.

Type1Lou
Type1Lou 2012-03-05 15:18:17 -0600 Report

In August 2010, I was admitted to a hospital in Pocatello Idaho while on vacation. My husband had been unable to wake me up, gave me a glucagon injection, and took me to the ER. Because I was not very coherent (conscious but barely), they determined my BG was seriously low and admitted me and ran all sorts of tests to be sure I hadn't suffered a stroke. I was released after 36 hours with no ill effects other than a ruined vacation. The care I received was excellent but the food I was served while there was not what I considered good for a person with diabetes. It was extremely high in carbs. I ate what I thought I should and left the carb-loaded stuff on the plate. At the time, I was on MDI of Novolog and Lantus. The experience pushed me to seek the help of an endocrinologist who got me back on track. (My PCP, when I saw him immediately after getting home told me to continue following his advice—-which was what got me into the predicament with low BG in Idaho!) The endo was WONDERFUL!…actually reducing my Lantus and getting me to use a sliding scale for the Novolog. In August 2011, I started using an insulin pump and am very pleased with it.

knutsoc
knutsoc 2012-03-05 19:01:57 -0600 Report

Good for you for taking charge of your diabetes instead of letting it rule you! I have worn a pump for over 10 years, and cannot imagine life without it now. I recently upgraded my pump and now also use the continuous glucose monitoring system. WOW! What a positive impact that has made on my control. It's funny, even my kids are excited about my new pump. (My baby is 21yrs old) I cannot stress enough that control is the key. You controlling the "Big D" Keep up the good work! -cathy

Type1Lou
Type1Lou 2012-03-06 08:35:44 -0600 Report

Thanks Cathy! I have learned, after 36+ years with diabetes that we all individually must take responsibility for how well or poorly we manage our disease. If we have problems, we need to seek help from the professionals. I had been having doubts about my PCP's approach prior to the Idaho incident but that was the impetus to seek out a specialist which has made a world of difference in my control. My PCP should have referred me to an endo but I finally asked him for the referral.

mysticangel49
mysticangel49 2012-03-05 12:44:27 -0600 Report

mysticangel49

I was in the hospital about 2 weeks ago. I had my med list in hand when i checked in. I am on oral meds as well as insulin. I was given nothing for over 24 hours. I was not allowed to eat anything or drink anything until they found out what was wrong with me. I had surgery the next day and still no food or drink. They started checking my blood sugars after i had the surgery. They were well controlled at home, but were over 200 each time they took them in the hospital. They would only give me regular insulin and that never brought my levels down they stayed the same. I am on a long acting insulin of 96 units at bed time and I kept telling everyone this, but I never got the insulin. They had me on very few of my med on my list and when i questions them they said they would leave a message for the surgeon. I would talk to the surgeon and i would still not get the insulin or any of the other meds i was supposed to be taking daily. I really dont understand how they can be so careless with a person. I am back home and my blood sugars are under control again.

Caroltoo
Caroltoo 2012-03-05 16:53:05 -0600 Report

So sorry you had this experience! I encountered something similar and don't understand it either. Glad you are home and doing much better. Keep on taking care of yourself and healing.

TsalagiLenape
TsalagiLenape 2012-03-05 09:37:00 -0600 Report

OK peeps here is an Idea ok? Like Jan8 did go after your final meds and etc if you can wait. Yet make a plan. If you FAIL to PLAN, You PLAN to FAIL! Now what you can do is be PREPARED. Get a 3 x 5 card. Put your name birthdate and medical info like your meds, what you are allergic to. What the doctors and nurses should be aware of, to check on you for. Main thing is to ask if this was You or Your Family Member do for me what you'd do for them. Use your Professional knowledge to help me so I can help myself. On the opposite side, put down IN CASE OF EMERGENCY. Dont forget to put ICE in your cell phone so EMTS and first responders know to contact that person if you are out of it. Also make sure your contact person knows of your card. Once you have your card done, get it Laminated! This way its waterproof and you carry with you at all times. Hope this helps as it was meant too. Hugs

Jan8
Jan8 2012-03-05 08:05:28 -0600 Report

I was in the ER for 8 hrs before they could get me a room. No food, or insulin. No peripheral neuropathy meds .My feet were burning up.I kept crying. I was severly depressed there for my shoes were taken ( they help my feet). It was the worst experience I had ever had in the hospital. By the time I got to my room it took about another 6 hrs to get my medication,talk to a social worker to be able to get my shoes and socks back, and by then my entire body was burning. When i finally got my insulin they accidentally gave me too much and I had a severe insulin reaction. I could not speak. I had been asleep and when I woke up,I kept whispering help then everything went blurry. This happened 2 times during my stay. There has not been a single time during hospitilizations a med dose was mistaken,or I was offered a med I was not suppose to have. I know all of my meds. I,and they knew all of my allergies. It would be great if there had been someone with me however they all have to work. The very last time I went to the ER I went after my pm meds and the last insulin of the day ( 8:30 pm). That way, I had taken all my meds and was covered by my insulins. It's a much better way of going to the hospital and by morning i had been taken to my room and had slept all night. I told the medical director what had happened and asked to be a direct admit ( they use to do this). She said that the policies require a visit to the ER before they can admit a person. I told her it would be a cold day in Hell that I would ever go to their hospital again. Anyone else have this problem?

annesmith
annesmith 2012-02-10 22:51:18 -0600 Report

When I was in the hospital in 2005, it was for my diabetes and my heart. I was having a light heart attack, and my sugars were really weird before I got admitted. The Metformin I had been taking was killing me, and they knew that before they took me upstairs to my room. Overnight was great..outstanding, but, the next morning ( I had nothing to eat for 12 hours because the Metformin cut off my appetite, gave me internal bleeding—I had lost 2 pints of blood and the night before they almost wheeled me QUICK to intensive care to open up my stomach), but, the next morning, I am SHAKING like a LEAF and then some more. The morning nurse comes in, holds her hand out, does not even bother asking me if I had breakfast, and , in her hand is a LARGER dose of Metformin. I was shocked. She grabbed a glass of water on my table next to me, and said " HERE, take these 4 Metformin." I paused, and said " OH, my GOD..NO…are you crazy?!" She said " It'll help you." OH, my God…I told her to take my blood sugar…it was 89…way too low for me. She said " Take it anyway." I said " No…I won't take it…look at how hard I'm shaking …if I take that, especially being I have not eaten for 12 hours, it'll send me unconscious…I'm positive of it." She did not believe me, SHOOK her head back and forth. She had an accent, oriental accent, so, I held my temper, considering she may not fully comprehend. I demanded to speak to the doctor. She said " Okay, if you won't take it, then you won't take it." It turns out the nurse was from another hospital. The hospital I was in is always , and always has been outstanding. OH…it just scared me, as around 1:00am, I had a diabetic seizure in my bed, and my room mate shouted out for the nurse to come in real quick. The nurse put a big tube inside one of my arms and said I had lost 2 pints of blood from bleeding from the stomach, and it was rapidly rapidly dropping my blood sugars, then, the more blood I lost, the weaker I felt. I stopped bleeding JUST in the knick of time, thank God. I thank God for this. ANNE

EdnaShukis
EdnaShukis 2012-03-06 16:55:51 -0600 Report

So sorry to hear about your bad experience. I am glad you stuck up for your rights and refused the Metformin. We know our own bodies more than do others.

annesmith
annesmith 2012-03-06 23:38:42 -0600 Report

Yeah, thank you!! I was so surprised about the big miscommunication , but am glad I was honest with them…I had to be, or suffer the consequences..sincerely, ANNE

Tender Tips
Tender Tips 2012-02-10 22:40:10 -0600 Report

My blood sugar jumped to 350 a few hours after my hysterectomy; nurses immediately called my doctor and were directed to give me an injection of insulin (was not on insulin normally). Took about a day and a half to get it down. They were really on top of it though. For some reason though, when a student nurse did a finger prick, I got extremely light-headed-my BP had dropped to 50-weird!

Graylin Bee
Graylin Bee 2012-02-11 17:41:25 -0600 Report

My GYN and I discussed BG issues as soon as she said surgery to me. She had orders in place that insulin was to be given if my BG went over 150 and the dosage. Plus made sure I was tested prior to surgery. Then I also kept asking what my BG was while in prep and then after waking from surgery. I selected what to eat from the liquid diet, then regular foods after being allowed to eat solid foods. The nurses kep asking me what was normal for my BG level. It is very important to be your own advocate whenever possible.
Durig my prior hosp incareation I wasn't always able to speak for myself. Then my husband, a sister and my mother watched my ack But even when you can speak for yourself sometimes you have to be confident enough to override the authority figure who is trying to do you harm. Had an army of wound care nurses in my room one day withing 10 minutes of a Dr's visit. He had thought it was his right to undo wound dressings and then walk out. I had to convince the nurse how vital it was to get them dressed ASAP and not after her lunch break. Luckily she called the wound care nurses. If she hadn't I would have been screaming my head off until someone came and listened to me. Too bad the Dr wouldn't listen to me that day. He did listen to the Head Wound Care nurse however and never repeated his actions.

DeanaG
DeanaG 2012-02-10 16:19:45 -0600 Report

My only experience with hospitals was when my Dad was in the hospital for surgery. After the surgery they couldn't get his blood sugar down.
When I got there and he told me about his sugar being high I checked his IV stand and discovered they were pumping him full of glucose. I told the nurse to get the glucose out of his IV, he's a diabetic and she informed me they couldn't change anything on his IV until the doctor came in and gave them the ok. It took me throwing a fit, threatening to remove the IV myself and getting the nursing supervisor involved to get them to remove it. I then promptly called the doctor and told him he better get to the hospital and double check his meds before they end up putting him into a coma.
The same hospital hung a bag of glucose in the ER during a different visit. When I got in there I ask the nurse why are you pumping glucose into a diabetic that is not suffering from low blood sugar? She said "oh my goodness we didn't realize he was diabetic" and I pointed out his medic alert necklace that clearly stated "insulin dependent diabetic".
I hope if/when I ever have to be in the hospital I have someone to look out for me.

Tess K.
Tess K. 2012-02-02 20:00:33 -0600 Report

The last time I was in hospital for inpatient stay was in 2005 for a knee replacement. My doctor was not a member of that hospital so they assigned me a very capable and caring doctor. This doctor was on top of everything and reviewed meds with me and the nurses. Having this doctor assigned to me made this experience better than I expected, he also arranged for dietitian to discuss menu with me.

jayabee52
jayabee52 2012-02-02 16:41:30 -0600 Report

I had to act as a go-between between my bride Jem and the hospital. Especially the ER. She and her health care team had her meds down to a science and for some reason the ER docs took her visit there as permission to fiddle with her other meds too. She would come in with RA related symptoms and needing some RA meds, but they decided to take her off her one kind of insulin and put her on another kind. I was supposed to juggle all of these goings on (and I don't do conflict or chaos well ) I would sometimes sound like a broken record to the ER docs, reminding them we were there to do something for her RA not her diabetes.

Old-n-Grey-n-Wiser
Old-n-Grey-n-Wiser 2012-02-02 15:44:20 -0600 Report

The last time I was hospitalised I Was still on orals, when they went over my med list I was taking Starlix and was told I would have to bring my own as they did not stock that med in their pharmacy.
Tom

re1ndeer
re1ndeer 2012-02-02 13:21:19 -0600 Report

I have been in the hospital several times. The first time I let them administer the meds. I never got the meds I was supposed to be taking, they switched meds to what the hospital doctor wanted to give me.
The second time I went into the hospital I took my own meds with me (including both insulins). I informed the staff that I will be responsible to administer my own meds (and do my own Blood glucose). I had to sign a waiver that the hospital will not be responsible if any thing should happen to me.

door331
door331 2012-02-02 14:11:32 -0600 Report

I wish my hospital had let me do that. I wonder if there is some sort of advocacy law that would force them to let me sign a waiver next time.

Caroltoo
Caroltoo 2012-02-02 14:13:36 -0600 Report

Refuse to cooperate with their protocol and it forces them to let you sign a waiver because they are afraid of the liability issues if they do not.

red flower lady
red flower lady 2012-02-02 15:40:18 -0600 Report

They are liable as well when they don't give you the meds you need at the times they should be given. This is not only neglect, but can cause other serious health problems. You would think they wouldn't want a law suit either way.

door331
door331 2012-02-02 14:28:08 -0600 Report

I will definitely attempt this next time— hopefully there won't be a next time though, I try to stay out of the hospital as much as possible. :)

Caroltoo
Caroltoo 2012-02-02 14:11:16 -0600 Report

The one time I was hospitalized it was for a heart attack. At the time I was taking only Actos and always carried a week's pills with me. When I was admitted, the intern went through a long list of what they would/would not do and it ended with "and we will give you injections." A few more comments, then the question, "OK?" Thankfully, I was very aware and said, I'm not taking any injections, what I am I agreeing to let you inject? (Something about the way this was stated told me that they weren't talking about antibiotics.) The immediate response was: insulin. My response was: NO.

She blinked, took a breath and repeated the whole 5 minute presentation right down to the "OK?" and my "No". She started on it a third time and I interrupted her … told her the result would be the same and asked her what her problem was. She said I needed insulin; I said I would not give permission to start it, assured here I had Actos with me, and needed to see the hospital dietitian to get appropriate meals. I had tests, had stents, got better, and on the day I was to be released, the dietitian showed up and all she could do at that point was apologize and tell me I had handles my meals very well because my BG was in control the whole time.

Needless-to-say, when discharged I wrote a rather scathing letter to the hospital administrators about the protocol's lack of sensitivity to individual needs, placing hospital concerns first, and not providing diebetic friendly meals. My take home lesson: always go prepared with pills or whatever meds you are using, stick up for yourself, and carry your own healthy snacks.

red flower lady
red flower lady 2012-02-02 16:09:33 -0600 Report

I was taken by ambulance from the drs office with a pending stroke/heart attack. Blood presure off the grid! While there they were informed of my insulin usage and all meds. I was there at 8 am and had not been given any insulin or food intil dinner time!
My family kept asking and was told they were on it, finally the nurse told my daughter to go to the vending machine to get me something to eat. When she said she would go get my insulin and bring me food back, suddenly a nurse showed up with injection and a brown bag meal, of course non of it was for a diabetic. Needless to say my family stayed with me the entire hospital stay, and brought all my meals to me and had my insulin there in case it was not given to me in time. This did not make the staff happy, but you don't mess with my daughter, she is not a push over and knows her meds.

She wrote a letter as well as demanded a meeting to discuss my treatment. I was put on a cardiac/diabetic meal plan and not once did I ever get it. My family took pictures of each meal and posted them on facebook along with a posting of what was going on. We also informed our insurance company. Not once, did we ever have to sign a waiver. I did have surgery at a different hospital, and you could not have asked for a better experience.

Sopies Grandma
Sopies Grandma 2015-02-16 07:39:23 -0600 Report

OH MY GOSH, I am so scared after reading all these posts of horrible hospital stays. I glad to hear that everyone survived the hospital but wow oh wow. I sure hope I don't end up in one of these situations. :)

'Second Chance'
'Second Chance' 2012-02-02 16:39:35 -0600 Report

Hi red flower lady, I hope you're feeling better, I'm so sorry to hear you had such a bad experience at the drs office, and later at the hospital!!!! That goes to say, how we must take charge of our disease, and stay on it, just like you and your family have done!!! I'm praying that, from your experience, and talking with the right personnel, this won't happen to anyone else!!! Through it all, I'm happy to hear that things worked out for you, especially

runthe
runthe 2012-02-02 12:56:25 -0600 Report

I was in the hospital last week and the nurses took my blood sugar before each meal and gave me my Insulin when it was schedule. The only thing was that they did not give me my Actos which was fine by me. Every time the food tray came around the nurse made sure that it was a no salt and diabetic tray. I often got tea, low fat milk or coffee. The food was blah and nasty. (lol )I had a least 1 slice of whole wheat bread and either apple or orange. The only thing that I complain about was that after my heart cath was done I had to lay flat on my back for 6 hrs and I could not eat laying flat on my back so after taking my blood sugar for the night they gave me anl ow dose of insulin.

pixsidust
pixsidust 2012-02-02 11:23:26 -0600 Report

Any hospital I have seen allows you to pick what you want from a menu. You can put times 2 by something you may want more of such as green beans. It does not have to be all starch.

Type1Lou
Type1Lou 2012-02-02 10:17:04 -0600 Report

I was admitted to a hospital because of a severe low BG episode while on vacation in Idaho in August 2010 . I had been on MDI of Lantus and Novolog. My husband had administered glucagon but it had little effect so he drove me to the ER. (This was before I started using a pump in August 2011.) I was impressed with the care I received there but not with the food. The meals provided were quite heavy on the carbs. Not what I deem a good diabetic diet.

door331
door331 2012-02-02 09:30:26 -0600 Report

I had a pretty bad experience in the hospital. I did not bother to bring the issue up after I was discharged but it still leaves a bad taste in my mouth. I was in the hospital for 4 days. The entire time I had nurses checking my BG levels and giving me insulin— unfortunately they would not let me use my own prescribed insulin brand (which I had with me) or my own BG meter. On top of that I had to tell them my carb ratio, correction factor, etc etc so they could properly monitor my BG but they were terrible at it. They had me on 2 different antibiotics which I am sure were making it harder to manage. My BG would plummet and go super low so they would give me juice or glucose tabs to raise it up, then I would be too high later, and you know how the yo-yo effect goes. Basically I felt I could have done a better job had they allowed me to manage my diabetes with my own medication and regimen that my Endocrinologist had prescribed for me.

I wonder now if things would have been different had I been using a pump— they wouldn't force me to remove it would they?

For the record- I was in the hospital for a non-diabetes related issue.

Jeanette Terry
Jeanette TerryPA 2012-02-02 13:45:53 -0600 Report

I had a similar experience in the hospital a few weeks ago. I was admitted for pregnancy related issues, not diabetes related issues as well. I do have a pump and they wanted to take it away. I knew that was a very bad idea and had to talk them into letting me keep it. They did however monitor my bg for me and advise amounts of insulin, which were completely off from what I would normally do. It was a very frustrating experience.

EllieS
EllieS 2012-02-02 01:22:20 -0600 Report

I work in a hospital. The level of ignorance in regards to diabetes is distressing to me. We have yearly training, but still is just to complex for non diabetics to fully understand. Best advice is to always have somebody with you to advocate for your needs. And always pack your own meter.

Anonymous
Anonymous 2012-03-06 17:08:25 -0600 Report

I so agree… You have to be your advocate and if you become unconscious have an adult familiar with diabetes with you at all times!

Gabby
GabbyPA 2012-02-01 21:10:53 -0600 Report

My experience was not mine, but my mom's. After she had knee surgery they brought her up to the room where I was waiting. Of course you don't eat and it is a long time between meals and I was a little worried. When she was there her speech was a bit off, but since she chose to be awake during the surgery, i was concerned she might be going low. The nurses just waved me off. I told them I wanted them to test her to make sure it was the pain meds and not a diabetic episode. They finally did so, and it was the morphine, but I was distressed that they just assumed that was what it was.

The other thing was that as being a diabetic, they would not listen to her when she was feeling low. You have to have someone be there to chase the nurses down. It is very sad. Her meals always came with orange juice, even after several requests for other beverages. I just don't get it. Let's see...spaghetti and bread. Really? Whose nutrition are they looking at?

I often have to be just as pushy when my husband is in the hospital. I just hope that I have someone to fight this way for me. Or that I can keep my wits enough to fight for myself.

Speedie65
Speedie65 2012-03-05 09:16:03 -0600 Report

Hi, I have been reading all these hospital nightmares and totally understand… PRMS will never get me back in their hospital… certainly not if I am not able to speak for myself.. I have had several replacement joints there and every time you would think I was doing reasearch for a horror film… This last time I was put on some sort of diabetes medicine as I had been on sugar water for a day and a half, and my sugar was 218… and no food..and on pain meds… I HAD NEVER BEEN DIABETIC… Well, they gave me diabetes meds.. and then I went down a floor to their rehab. section and stayed another week… still taking meds they decided I needed… and after being out of the hospital, which I finally got myself thrown out of, after 6 months, my sugar was raised… NOW I AM A DIABETIC… I don't know if taking diabetes meds when you don't need them can cause diabetes for sure or not but I have been researching it and I think it can. If they had only allowed my body to do its normal thing, I am sure my sugar would of been where it should of been in a day or two… It was horrible… Needing to be your own advocate can not be stressed enough… Had I had to stay another night in there, I was not going to let my husband leave… It is a shame we have to worry about these types of things… but we have to… There isn't room enough here to tell you all my experiences, all bad… One time the nurse came in with blood pressure meds for me to take.. and the Dr. had just put me back in bed, after sitting up, was back surgery, because my B/P was so low he was afraid I would pass out… Thank God that I was able to say NO…she got very upset with me, but hey, I knew better… What would of happened to me had I take those 2 B/P pills not knowing that I didn't need them… hmmmmm.. scarey…!!!

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