Going to hospitaleditor
Going to hospital
A person with diabetes has a full time commitment to properly manage their disease following their diagnosis. That commitment increases if you have to go to hospital. Surgery for anyone can be traumatic but it shouldn’t be any more traumatic for someone with diabetes.
The key is preparation. It’s important that you are well informed, take an active role in your own management and plan well before the event.
Telling the right people what they need to know will also help make your hospital stay more comfortable and put you on track for a safe and speedy recovery.
The key is to be well informed
and plan well
When you go to hospital,
take all your current medications with you
Consult with your doctors
When making your appointment, it’s recommended that you request that your procedure is scheduled first on the morning list, to avoid disruption to your diabetes routine.
Talk to your diabetes team about the procedure and what to expect. It is also the ideal time to discuss liaison between your endocrinologist (a diabetes specialist) and the surgical team.
Any concerns you may have regarding the procedure or surgery and your diabetes management plan can be discussed with your medical team (including your diabetes educator) before and after surgery. Questions might include when you can eat, how fasting will affect you and if there will be any modifications to insulin or medication dose for any length of time.
Most hospitals have a protocol for managing people with diabetes undergoing surgery; however, it is advisable that the surgical team is made aware of your individual management plan.
Changes to your diabetes medication are often required before and after day procedures or surgery, particularly if you are taking metformin. Some patients are taken off oral medication for type 2 diabetes and put on insulin.
Be prepared for the possibility of having a ‘hypo’ while you are in hospital. Ask your specialist or educator what precautions you can take and acceptable treatments that can be used.
The day before the surgery/procedure
Test your blood glucose levels at least four times on the day before the surgery. You may need to adjust your insulin dose the night before because you will not be eating breakfast on the day of the surgery. Oral medications will be stopped if you are fasting and some, like metformin, may be stopped 2-3 days before the surgery.
People with type 1 diabetes need to inform the medical/surgical team if they have ketones in their urine prior to surgery.
The hospital stay
When you go to hospital, take all your current medications with you. An alternative is to have a list with you of all the medications, how much and how often you take them.
The type of insulin you use and the dosage may be changed while you are in hospital. You may be given intravenous insulin to control your blood glucose levels if they are high.
It’s important to maintain good blood glucose control. A number of recent studies have shown that patients who have good control while they are in hospital have better health outcomes with fewer infections and problems.
Following the surgery/procedure
Discuss the best ways of managing your recovery with your doctor or the person looking after the procedure.
When you are discharged, make sure you know what changes have been made to your diabetes management and whether to continue these changes or to revert to your original treatment plan.