1. Health
You can opt-out at any time. Please refer to our privacy policy for contact information.

Preparing for a Hospital Stay with Diabetes

By Craig Stoltz

Updated August 24, 2009

(LifeWire) - Maintaining stable blood sugar levels on a daily basis is challenging enough for a person with diabetes. Doing so while being hospitalized -- whether for major surgery, a minor procedure or treatment for an illness -- adds significantly to the challenge.

Here's the diabetes information you need to know

When a person with diabetes is hospitalized, many factors can contribute to variations in blood sugar or glucose levels. Stress, a different meal plan, various drugs, treatments and the illness for which the person is being hospitalized for itself can all come into play for a patient with diabetes.

It's well known that excessive glucose levels can slow healing and boost infection risk. It's clear that a tight control of diabetes before and after surgery significantly reduces sickness and even the risk of death.

Therefore, it is very important for a person with diabetes who expects to spend time in the hospital, say for a scheduled surgery, to prepare for careful monitoring of their stay.

Getting Ready for a Hospital Stay

If you or someone you care for is preparing for a hospital stay, talk to a diabetes specialist or another healthcare professional to get answers to the following questions:
  • Should the patient expect to control his or her own blood sugar levels while in the hospital?

  • Will the patient's condition allow for self-monitoring?
    If the answers to these questions are yes, then ask the doctor to write a "self-management order" for the patient. This will outline instructions the patient can follow on her own.

  • How will the treatments and medications affect the patient's blood sugar levels?
    This is particularly important if the patient is expected to undergo anesthesia.

  • Will insulin be prescribed during the patient's hospital stay?
    Sometimes people with diabetes who do not regularly use insulin will be given insulin while hospitalized. If insulin will be given, what advance preparations should be made by the patient?

  • What is the patient's proper range for blood glucose levels while being hospitalized?
    These may differ from the person's usual numbers. The American Diabetes Association recommends keeping blood glucose levels below 180 mg/dL while in the hospital; however, individual circumstances may vary.

  • People with diabetes have a right to have their own diabetes doctor or care team professionals monitor and maintain blood glucose levels while being hospitalized. Does the patient's doctor recommend this course of action?
    If yes, then what arrangements need to be made in advance? If no, then how will this be handled if the patient is incapacitated, groggy or anesthetized?

  • Once the patient returns home, what is likely to happen to blood glucose levels during the recovery period? How soon can this person expect blood glucose levels to return to their normal condition?

  • How soon after hospitalization will the patient be able to resume regular exercise, eating and medication regimens?

Preparing Hospital Staff for the Stay

Before the patient arrives, hospital staff should be consulted and informed. It is vital for everyone involved to be made aware that the patient being hospitalized has diabetes. It is also important that any surgeons, other doctors and nurses who provide direct care for the patient have knowledge of dietary needs, drug treatment and, if applicable, insulin dosing. The patient's meal plan should be provided to the hospital dietician. Ideally, this can be done by talking to the dietician before the arrival of the patient by reporting any special needs or preferences.

Many hospitals have diabetes educators who work closely with patients during hospitalization. If there is a diabetes educator at the hospital, speak to that person directly and discuss the following questions and issues:

  • Should the patient bring his or her own glucose, meter and drugs? Some hospitals require that patients use only those items provided by the hospital.

  • If the patient uses an insulin pump, how will treatment and care be affected?

  • Which medications -- including those for other conditions -- should the patient stop taking before the hospital stay, and when?

  • Will there be periods when the patient will be unable to monitor and treat their own blood glucose levels? If yes, then who will have direct responsibility for this monitoring and treatment plan? (Prior planning should be made by speaking to the patient's personal care team to ask what their role will be during hospitalization.)
Do not be afraid to be assertive and even redundant in communications with hospital staff. Two reports on medical errors have shown that insulin mistakes are among the most common type of serious errors in hospital settings, so it's important to make sure that everyone is well informed.

While in the Hospital

Once the patient with diabetes has been admitted to the hospital, the importance of thorough communication with hospital staff continues as follows:
  • Make sure the nurses know the patient's symptoms of high or low blood sugar and what the usual snacking plan is if the patient's blood glucose level drops. Sometimes glucose pills are used in hospital settings.

  • Ask if the patient can wear his or her usual diabetes ID. The patient's diabetic status will be on the medical chart, of course, but the ID provides another level of assurance that all hospital staff will be aware of the patient's diabetes.

  • If meals, medications or insulin treatments do not arrive at the appropriate times, alert the nurse. Again, do not hesitate to be assertive.

  • Make sure the patient's direct caretakers know if the patient is nauseated or has vomited. If meals or medications don't stay down, the care team will need to take other measures to control the patient's blood sugar levels.

  • Find out how long fasting and avoidance of liquids will be required before the procedure, as well as what plans are in place to ensure the patient's blood sugar remains within safe ranges during these requirements.

  • Ask how long after surgery or treatment will it be before the patient can resume a normal eating plan. What provisions will be made to control the patient's blood sugar levels during that period?

Recovering From a Hospital Stay

Once the patient returns home, careful monitoring of blood glucose levels remains important. Depending on the patient's condition, it may be helpful to have a friend or relative help with meals, medications and monitoring.

Visits and check-ins from members of the diabetes care team can be useful as well. Any friends and family who are assisting the person with diabetes should stay in contact with the care team until the patient is able to handle this personally.

Before the patient receives discharge orders from the hospital, the diabetes care team will review details about when and how the patient should return to his or her regular diabetes care regimen.

A hospital stay is stressful for anyone, but good preparation can help ensure a rapid and complete recovery.

Sources:

American Diabetes Association. "Patient Information: Diabetes and Surgery." /Clinical Diabetes/ (2001) 19:96. 14 Oct 2007.

American Diabetes Association. "Patient Information: Diabetes in the Hospital: Taking Charge." /Diabetes Spectrum/ (2005) 18:49-50. 14 Oct. 2007.

Clement, Stephen, Susan S. Braithwaite, Michelle F. Magee, Andrew Ahmann, Elizabeth P. Smith, Rebecca G. Schafer, and Irl B. Hirsch, on behalf of the Diabetes in Hospitals Writing Committee. "Management of Diabetes and Hyperglycemia in Hospitals." /Diabetes Care/ (2004) 27:553-591. 14 Oct. 2007.

Onufer, Cindy. "Could U Be In Danger?: Insulin. The #1 Drug Error in Hospitals." /Diabeteshealth.com./ 1 Nov 2002. Diabetes Health 16 Oct. 2007.

"Surgery Pre-Op Advice." /Diabetesmonitor.com/. 8 Jan. 2005. Diabetes Monitor 14 Oct. 2007.

LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Craig Stoltz has served as editor of The Washington Post´s health section and editorial director of Revolution Health. He is currently a consultant to several health-related Web ventures. He lives in Bethesda, MD.

©2014 About.com. All rights reserved.

We comply with the HONcode standard
for trustworthy health
information: verify here.