One of my biggest fears is ending up in a hospital or nursing home unable to advocate for myself, experiencing persistent hyperglycemia, and overtaken by DKA or a lethal infection. I’d like to think that hospitals and nursing homes are populated with professionals who understand diabetes because of its pervasive prevalence.
Nothing could be further from the truth. There is a sprinkling of health care professionals who do understand diabetes and are capable of effective, though not likely optimal, glucose management. On the whole, based on many anecdotal accounts gleaned from forums like this one, the sad truth is that our hospitals and nursing homes can produce the worst of glucose management practices and their institutional culture sustains that ignorance.
The typical doctor, nurse, or dietitian is often primarily motivated to avoid a severe hypoglycemic incident on their watch. Their main tactic is to run the patient’s blood glucose well north of 150 mg/dL. That is an effective tactic for avoiding hypoglycemia. But it’s simply a tradeoff for persistent hyperglycemia that comes with a whole host of other dangers.
Stacey Simms’ Diabetes Connections February 8, 2022 podcast was an interview of T1D Molly Schreiber. This podcast was primarily about Molly receiving a rheumatoid arthritis diagnosis on top of her T1D status.
A sidebar to her story featured her T1D father and his experience showcased my most vulnerable fear. Fast forward to about the 32-minute mark on the link below to hear Molly describe what happened to her father.
He suffered a blow to the head at home from a severe hypoglycemia incident. That put him in a nursing home for recovery and rehab. The nursing home staff refused to give him any insulin. He repeatedly requested insulin and they just didn’t deliver. Maybe their experience of the overwhelming population of T2Ds taught them that withholding or delaying insulin is not critical.
All the details of his case were not given but, bottom line, he fell into DKA and died. This man was five years older than me. Yeah, that got my attention.
Something needs to change! There’s a huge swath of ignorance in the hospital and nursing home institutions and the worst thing is that these institutions are unaware of their ignorance. This is a dangerous recipe sure to kill more of us. What can we do?