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Hospital Stay & Diabetes Management

9864 Views 44 Replies 12 Participants Last post by  MinisMom
When I was in the hospital the first week of August, I was concerned about how I would manage my diabetes. Medications are usually given 4 times per day except PRN meds. The hospital did not use carb counting so I needed to come up with a sliding scale for my Novolog injections. With the help of my doctor, we came up with a decent dose that would cover meals, the increase due to infection and to cover the increase in blood sugar due to the steroids that I am on. We settled on 25 units at mealtime and I am used to taking my Novolog after meals but found that this was going to be difficult to get my shot at this odd time so I took the chance and was getting my Novolog before meals, this made me nervous to say the least. And then I was nervous about the size of the carb servings, which were mostly small except for the "modified mashed potatoes" that was served nightly. I would get my blood checked at 6AM, 11AM, 4PM AND 8PM. I remember one morning I tested at 65 and you would have thought this was the end of the world. The nurse brought regular chocolate pudding, 3 packs of graham crackers and a carton of milk and told me to eat up. I ate the pudding but didn't eat the rest and they kept testing my blood glucose to see if it had come up. I explained that this was a low number but not for me. If I would have eaten everything that they told me to, I would have then been high. And what they gave me to eat was not exactly fast acting carbs. I also had several times when I got my Novolog 2 hours after eating and then I was due for more Novolog in 3 hours and refused a couple of shots. Diabetes management really needs to be stepped up while you are in the hospital. If there is a next time, I will have my glucose meter brought from home and will smuggle in my own Novolog. Oh, they also don't stock Lantus so I was using Levemir.
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Never forget that you always have the AMA (Against Medical Advice) option. You can refuse any part of your care. You can also simply leave the hospital. The hospital policies are indeed in place to cover the ass of the hospital, not ensure optimal care. I ought to know, I'm a nurse who actually worked in a hospital for a while.

I agree that it would be a fine idea to have a specific diabetes self-care standing order from your physician, much like your advanced directive. Keep a copy in your hospital record, and you keep a copy at home, too, for when they lose the copy in your records. But the hospital will hate it.
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