Going to hospital
Spending time in hospital can be stressful for anyone, but it shouldn’t be any more difficult just because you are living with diabetes. Preparation is the key to making sure your hospital visit goes as smoothly as possible. Take an active role in your diabetes management and plan in advance to give yourself the best chance of a positive experience and a safe and speedy recovery.
In preparation for your visit
Most hospitals have a protocol for supporting people living with diabetes when they undergo surgery. Before going to hospital talk to your doctor, endocrinologist or diabetes educator about the procedure you need to have, what to expect and how it might affect your diabetes management plan. Ask your doctor how your information is going to be passed on to the endocrinologist (a diabetes specialist) and your surgical team. Should surgery be required, you should make the surgical team aware of your individual management plan in advance so they are prepared.
When you make the appointment for your procedure, ask that your procedure be scheduled first thing in the morning as this will help to reduce the impact on your usual diabetes management routine. Changes to your diabetes medication are often required before and after day procedures or surgery, particularly if you are taking metformin.
Be prepared for the possibility of having a ‘hypo’ (an episode of diabetic hypoglycaemia) while you are in hospital. Ask your specialist or educator about what precautions you can take and which treatments will be safe for you to use if this happens.
Questions to discuss with your medical team might include:
- When you can eat and what you can eat
- How fasting might affect you
- Whether your blood glucose targets will change
- Whether you will need to change your medication before, during or after the procedure
- How often you should be checking your blood glucose levels.
Lastly, if you need an interpreter, make arrangements in advance. Public hospitals have a free interpreter service available for you to book.
The day before your surgery/procedure
Check your blood glucose levels more often (as advised by your doctor), keep a record and aim to keep them within your target range if you can. If you are taking insulin you may need to adjust your dose. Your doctor will advise how much to take.
Diabetes tablets will be stopped if you are fasting and some, like metformin, may be stopped two to three days before surgery.
If you have type 1 diabetes, check your ketone levels as you will need to inform the medical/surgical team if you have ketones in your urine prior to the procedure.
Pack all of your diabetes supplies such as hypo treatment, blood glucose monitoring equipment, blood glucose record and a list of your current medications (both prescription and over the counter), including how much you take and how often.
During your hospital stay
When you go to hospital, provide the medical team with your list of medications and any information about your recent blood glucose levels or ketones.
If you are taking insulin, both the type and dosage you use may be changed while you are in hospital. In some cases, you may be given insulin through a drip rather than how you usually take your insulin.
Maintaining good blood glucose levels when in hospital helps promote better recovery outcomes with fewer infections.
Following your 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 plan and whether you need to continue these changes or revert back to your original treatment plan.