Susan B. Sloane, BS, RPh, CDE, has been a registered pharmacist for more than 20 years and a Certified Diabetes Educator for more than 15 years. Her two sons were diagnosed with diabetes, and since then, she has been dedicated to promoting wellness and optimal outcomes as a patient advocate, information expert, educator, and corporate partner.
To err is, indeed, human. We all know that saying, and there are many checkpoints in place in the hospital setting to reduce, or hopefully prevent, medication errors from occurring. But unfortunately, medical errors still occur, so it's important to be an active participant in your treatment, either by yourself or with the help of an advocate.
Statistically speaking, medical errors are the eighth leading cause of death in the U.S. And despite being around since 1922, insulin has a high incidence of errors associated with its use in hospitals. A study in England and Wales showed that one in every five insulin-using patients hospitalized is a victim of a medication error.
The purpose of this is not to alarm or scare you but to help make you a participant in your healthcare—not just an observer. If you are unable to watch over yourself, assign a family member or friend who is familiar with your care regime to do so for you.
The goal is not to question everything a healthcare professional does in a hospital; it is not their “intent” to harm you. Most hospitals have many checks in place for safety in drug delivery, but no one knows your body as well as you do.
Precautions to take
When you get admitted to a hospital, whether you use insulin or not, the standard protocol for the staff is to use insulin rather than oral meds. It is a good idea to discuss this with your medical team and let them know how your blood sugars usually run. Surgical procedures or any insults to the body, such as an infection or a virus, will make the body more insulin resistant, and you may require more insulin than you are used to.
I suggest letting your doctors and medical care team know what your usual insulin-to-carb ratio and insulin sensitivity factors are before admission. The insulin sensitivity is basically how much one unit of rapid-acting insulin would lower your blood sugar, as a rule.
The problem with hospitals is that they standardize care much more than they individualize care. This is due in large part to the huge volume of patients they service and the need for general protocols.
General protocols, however, do not work all the time for patients with diabetes. If you have never used insulin and the plan is to give you insulin in the hospital, work with your healthcare team to understand what to expect. I would advise family members to carry blood glucose meters with them and have them available for a quick check if necessary so that you can alert the hospital of a potential problem with high or low blood sugars.
Some institutions give rapid-acting insulin after a meal in the hospital rather than before. This could be a very good thing, as some patients in the hospital don’t feel like eating and some just don’t love the food.
Again, I do not want this to scare you, but rather I want to encourage you to be an active participant in your healthcare. Any and all family members and loved ones should be involved as well.
Take care, and let me know in the comments below how a hospital experience went for you, and if you have any good tips for our awesome community.