Can your insulin pump be taken away while in the hospital?

Type 1 and LADA
1

I have rarely been an inpatient in the hospital and never for diabetes.

I was shocked that the diabetic educator wanted to lock up my insulin. I flatly refused to go along with that, but I am wondering if wearing a pump would have kept them from even suggesting something so shocking.

I don’t know how pumps work. Could a medical professional still control doses?

I am thinking about any future time spent in the hospital. I need to control my insulin and my body.

Oh this is funny, a nice woman took my food order, but the dietician refused my order because I ordered hummus. She said that I couldn’t have hummus, because I was on a low fat diet. I realized that hummus has fat, but I wasn’t eating anything else with fat the entire day and I wanted a treat and it was vegan.

I told the woman that I put myself on the low fat diet and I could eat it. She had to go back to the dietician to get my request approved, but she brought the hummus.

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When I’ve been hospitalized, in-patient or out-patient, I was able to keep my OmniPod, PDM, Dexcom, and Receiver with me at all times and I had control, except while I was in the OR and then the anesthesiologist had them.

My diet was a regular diet, so I could control what I ate. The first admission it was a diabetic diet and I wasn’t able to not have loads of carbs; I had it changed while I was still an in-patient. I learned then I had to make sure I had regular diet on admission, so I could order what suited my way of eating.

Both my surgeon and admitting doctors permitted me to have control of my pump. My endo isn’t a part of the hospital system, so I’m not sure if they were even contacted. My A1C hovered between 4.8 and 5.5 at the time, so they knew I could manage it better myself.

Our family physician refused to let my husband have the same control with his recent admission (mdi not a pump). We never asked his surgeon about it. Doctors are all different.

Hold your ground. I’ll send some good energy your way!

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It depends on the hospital, and why you are there. If at any point you are heavily medicated, will you be capable of making safe decisions?

Some hospitals are more adaptable, depending on your condition and what procedures are being done. Some will allow you to control if your endo basically agrees and takes responsibility of judging you are capable.

I think legally, yes they can take it away. My last 2 stays I had to sign papers to basically say I would not sue them if I screwed up, and I was allowed all dosing except during extensive surgery with IV insulin drip.

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I’m sure policy varies per hospital, even probably who’s on staff at the moment. But since a pump is attached, it would be much harder to take from you. My Omnipod has a separate pdm, so I suppose that could be touchier, but I expect you could speak up and say you have to be able to adjust the doses on the pod that is pre programmed and already attached and it would be okay. It is supposed to be easier to keep a pump at the hospital.

I have been assured by the diabetic educator here who’s main job is at the hospital that we are allowed to keep our pump and control our insulin as long as we aren’t in there for DKA and then not even she will allowed to control her insulin.

The next trick would be how sick you are in the refilling of the pump, it only takes a few minutes but you also have to have insulin to put in it about every 3 days.

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If I was in surgery, in the recovery room or very very ill, I would have no complaints about letting someone else take over. I just want control as soon as I am capable of caring for myself.

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I agree with you, @Marilyn6. If I’m capable then I want full unrestricted control of my insulin delivery. Hospital marketing programs make a big deal about individualized care but unthinking adherence to these blanket policies do not take into account the insulin dosing ability and experience of patients like yourself.

Granted, there’s a place and time for this type of policy but they need to thoughtfully consider the actual circumstance before they jump on board with administering a broad stroke policy. Perhaps this diabetes educator was simply scoping out your reaction in order to calibrate her action.

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I wasn’t too pleased when the preop nurse called to talk about my husband’s upcoming surgery. He was at work, so I spent a few hours throughout the day talking with her. Their protocol calls for no basal the morning of surgery and no metformin. I questioned this because all I’ve ever read is to keep our numbers good to promote good healing, yet they wanted him to be running high. …

(I’ve been wanting to tell this story for over a week now … so, here goes.)

… Then, I was reminded, by an outside incident involving another person, why hospitals do this and I was humbled by the experience. My husband and I were at Church about 18 hours before surgery and about halfway into Mass, the fella one person away from me fell forward. His wife and the person to his other side and the guy behind, caught him. I noticed his wife pulled out a dex tab and gave it to him.

This was a special event and we were dressed up. I had my Dexcom and had my husband put a half dozen hard candies in his suit pocket - oddly, I tend to run low during Mass. I was running late and didn’t want to go back upstairs to change purses and the purse my D-bag was in, wasn’t the right color or style; we were packed for travel (about 100 miles away for surgery). Argh. Lesson learned. I thought I could go the 90 minutes without it, as we were coming home to change into travel clothes right after Mass. I could have. But, the fella next to me could have benefited from its contents.

I had my husband give me a candy and passed it down to him. Then another, then I had one of the ushers get him some juice. In the end he had two dex tabs from his wife (that was all she had on her), I had passed him four hard candies, and then a glass of juice from the usher.

We offered to go out to the car to get our spare glucometer to get a reading, but they didn’t want it. Had I had it on me, I could have easily tested him. Plus, my glucagon is in there and more dex tabs … argh.

The reminder which humbled me was when his wife said to me, “I worried this would happen. He had his insulin this morning, but hasn’t eaten yet.” It was now 2:30-2:45 in the afternoon.

I’ve heard where people will up their basal to account for food intake during the day/night or for meals. I don’t do that. My basal keeps me flat if I don’t eat. We’ve gotten my husband’s to the same point; he doesn’t need to eat, to feed the insulin, but being mdi, he can’t get as flat as I can with multiple basal rates.

Anway, I now appreciate what hospitals are up against, preop. I’m still miffed that they don’t test before he eats and prebolus or even bolus with his meal. No, they test and bolus a few hours later. He’ll be home soon and I can get him back on track!

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I’ve been in hospitals with my pump more times than I can count–I always control and keep my pump. During surgery it’s running at a rate that is safe and as always I shoot for being a bit high to keep myself safe, sane and keep the doctors happy. The doctors do NOT know how to operate them. The only thing I’d ever want one to do would be if, after showing them how to STOP the pump, they did so if it were an urgent issue. that hasn’t ever happened. If the anesthesiologist needs to give me a bit of insulin, it would be done thru the IV–not thru my pump! Always discuss that you are wearing a pump PRIOR to surgery–it has never been a problem for me, or for my wife who has had a procedure or several, while wearing a pump.

If, for reasons of extended-time pain control, one is very loopy, then additional instructions to the staff will need to be given. For example, if on a heavy morphine drip it is best to have staff monitor your bg’s and perhaps one should even lock the pump to prevent foggy-brained pumping mistakes. A locked pump will continue to provide basal, in case anyone is wondering.

I nearly forgot one thing. Staff will periodically use their own hospital-provided meters to test bg’s even when it is known that the patient is self testing with their meter and/or using a CGM.

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So glad that your husband will be coming home soon Tapestry, so that you can get him back on track.

Also glad that you could help the guy in church. I know that I am old fashioned but I never give insulin without eating. My worst fear is not having enough glucose in my purse to save myself, so I probably carry more than I need.

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Literally? You never bolus to correct a high bg?

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If she hasn’t, bet she will soon now that she has her shiny new Dexcom G5:rofl:

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LOL! you may be right!

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Oh sorry Dave. I don’t give pre meal shots without eating.

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That diabetic educator was using ‘fighting words.’ Shouldn’t be tolerated.

Check out this post, Marilyn: Insulin at the hospital

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Believe me Mohe, I didn’t tolerate her words. Once I was released though, she called me and kindly helped me set up an appointment with a new cardiologist. So not all bad.

The article you linked sounds horrible. That hospital is just waiting for a law suit. Glad that woman survived.

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I also went through the you have to disconnect your pump for the stay routine. And I told the attending that wasn’t going to happen. So 30 minutes later a CDE came in and talked with me for a few minutes, tried again to get me to disconnect and failed. She came back 30 minutes later with a bunch of forms I needed to fill out and sign so I would be attending to my blood sugars.
Thankfully, I filled out all the very outdated forms (sliding scale?), and stayed overnight in observation waiting to do stress test and echo test the next morning. They wanted me at 150 before test. No problem with pump and CGM all working.
When I saw my endo a few weeks later, I said it was because this hospital has no endo in the building but one on call. And I should have made them call the one call doctor. But I felt I handled it pretty well! I got what I wanted and they didn’t have to think about my diabetes except for recording my blood sugars that I did and insulin that I gave myself.
And when I had my two children, it was written in the orders that I had control over my own dosing. So very cool when you and your medical team trust each other!
Hopefully you are heading towards a complete recovery! Hoping and praying for you! Keep fighting for what you need and want!

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Of all my stays in hospitals for surgery, only one, O’Connor Hospital, San Jose, had a jackass administration that made me sign forms right after I fired the idiotic, dumb, moron-of-an endo that I had for my hospital stay because it was across town so my regular endo didn’t have hospital privileges. That had to be the most stressful hospital stay I’ve experienced. Not only was the surgery devastating, but the care and admin was the pits. How that endo ever got or kept his license was beyond me. I think my blood pressure goes up just thinking about it, which occurred in 1995.

At another hospital which is excellent, my very good endo that I had for a short time, calculated the amount of insulin to be infused into the IV bags that I was on for about 4 days. He was brilliant and I have never had such great bg’s in all my years as a diabetic, but that takes an endo who REALLY KNOWS HIS STUFF!!

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The last time I was in the hospital, everyone had their act together as far as letting me control my diabetes. The paramedics that picked me up didn’t do a finger prick because I gave them the number from my CGM. Likewise in the ER. No one asked for any details once they saw my CGM and pump.

When I got to the room, no one asked for my pump nor did they take a finger prick. The asked for my BG which I supplied from my G6.

They did give me grief about a prescription med my wife delivered. They took it to have it to get their pharmacy’s stamp of approval. But when the saw it was from a Canadian pharmacy they told me I couldn’t use it. I told them I’d walk out if they didn’t let me use it and they backed down.

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You were transported to the ER for what I presume was an emergency, but you said you would “walk out” if you couldn’t use your med. Had they stabilized you to the point where you could have permanently left the hospital at that point?

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They admitted me for observation, which I felt was overkill but I begrudgingly agreed to do it. Wouldn’t have bothered me one bit to leave as that was my instincts prior to admission. I was brought to the ER from my gym after I passed out from dehydration. When they did the blood work in the ER my CK level was elevated which to me was a ‘duh’ because CK levels normally rise after a vigorous workout. When I talked to my regular doctor after discharge he said there was no reason they should have kept me. He said they should have sent you home with instructions to have a follow-up CK level measured a few days later.

Should have also mentioned the medicine is EXTREMELY expensive in the US ($35K/year), which is way I get it from Canada. I could only imagine what they would charge me for a couple pills…

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