Terrible care the last two times went to hospital

I was in the hospital last year due to namoneia and the doctors put me on steroids to help me breathe and this is what happened… My bl would not go under 300 for about 2 straight days for example I would wake up at around 270 take double my dose and eat and every 2to 3 hours thAt I kept testing kept registering at 270 to 400 … And when I told the nurse who was treating me about what my numbers were all she said to me was " well you must be eating to much as a diabetic you need to watch what you eat … Well obviously I know this because I’ve been diabetic for 22 years … But what drives me crazy is that a registored nurse who works in a hospital doesn’t know that when you have type 1 your blood sugars can go high even when all you’ve eaten is nothing … Therefor I am so scared of ever having to be hospitalized in the future because I’ve noticed that if the dr is just a regular md and not a specialist like an endrocanoligist they are in the dark when it comes to type one … Just this past Thursday I had my first root canel performed and I said to my dentist do you think that my problems that I’ve been haveing with my teeth is the reason for my bl running high all the time and this was his reply" well high bl are usually caused because a person has diabetes not the other way around …he was pretty much telling me that teeth problems do not cause a person to get high bl diabetes does …so he answered a question that I did not even ask him

Congratulations on not hitting the nurse over the head with an IV pole when she told you that you were eating too much! Not only does she seem to be implying that what you might have eaten last week made your blood sugars high today, but she also doesn’t realize that hospital food sucks for blood sugar control!

think you got hit with a double whammy there, trying to manage diabetes while hospitalized (with a bunch of idiots for staff!) and needing steroids which are notorious for jacking up our blood sugars.

I haven’t had to be hospitalized, but I know as I get older that may happen one day. After all the horror stories I’ve heard about trying to manage a medical condition in a medical facility…which you think would be a good place for it…I’ve realized that the first thing I want to do if I am going for a hospital stay is to have my doctor write an order allowing me to continue to manage my own diabetes while I’m there. As in “Don’t you dare touch my pump if I’m still conscious enough to push buttons!”. The second thing I want to do is get my friends and family on a rotation of stopping at the Whole Foods two blocks from the hospital and bringing me salads. Does Whole foods make scrambled eggs? We were talking at my Type 1 Group today about how a common breakfast food in hospitals is pancakes with syrup! Pancakes. With syrup. Now that’s good nutritious food for anyone trying to get their health back. Let me see: Carbs, carbs, carbs and carbs. Yep, all the food groups.

The doc RXed steroids for me in like week 4 of a nasty cough. I tried 150% for my basal rate and it put a dent in the BG spikes so I turned it up to 200% and it worked ok. I didn’t really get it from a doc, I just knew that steroids raised BG in sort of a systemic way so it made sense to me to turn up the basal. I’m not sure what people in the hospital would do with me though.

My dentist is pretty young and is all over my teeth to make sure they are ok. I think that’s a two way street as if you get an infection in your mouth, and gums can get sort of endimically inflamed, it can push your BG up in the same manner as steroids or being sick I think?

I think that’s a two way street as if you get an infection in your mouth, and gums can get sort of endimically inflamed, it can push your BG up in the same manner as steroids or being sick I think?

AR,

My dentist told me that yes, this does happen.

Trisha

Definitely devise a hospital plan, if you should need it (hope not), that includes someone to be your advocate & watch dog. Hospital staff are staggeringly ignorant about diabetes. My “diabetic” hospital meals, after DKA, were pancakes, cold cereal, oatmeal or French toast, grilled cheese white bread sandwiches with potato soup, spaghetti with meatballs & one dinner had both mashed potatoes & corn. Snacks were sugary cereal with skim milk or granola bars. The nod to diabetes was sugar free pudding for dessert. Airline food is gourmet by comparison.

Everything everyone else said. You need to have an advocate there at all times, except when you are asleep, because hospitals do their best to kill you. I had a coma last year, and while the ER did save my life (after being sure it was drunkenness or dementia), the treatment I received on the floor was atrocious. They had a hospitalist who assumed that, because I was 62, I must have Type 2, and they used Type 2 protocols on me, which were insulin only before meals, and then only to correct a high BG, but not to cover the meal, and no basal. And then they couldn’t figure out why my BGs were going up and not down. They COULD have consulted my endo, who was on the record, but NOOOOO!!! Fortunately, there was a CDE on my case, and she convinced them to use Type 1 protocols, and my BGs finally started coming down. Then they discharged me to a rehabilitation hospital/nursing home, because I was no longer acute, and we went through the same game all over again. Except it was a weekend, and because they only gave insulin on a sliding scale before meals, I was left to sit with BGs over 400 for hours. NO, you can’t have any insulin because it’s not time yet! It took 3 days to corner the hospitalist and get him to let me have a basal and boluses and corrections. And that set me back so much that it took 3 weeks to get my BGs under semi-reasonable control. Fun sitting in a wheelchair with all the Alzheimer’s patients, yes? Well, my brain was so fried from the high BGs that maybe I didn’t appear too much different from them!

So my advice is to make sure you endo is consulted on your case, and never trust a hospitalist – they might be OK for Type 2, but they haven’t a clue about Type 1, especially if you’re older. And insist on speaking to the dietitian – they CAN give you low-carb meals if you insist. You may have to have your advocate make a stink, but if you have to, then do it. If you’re unconscious or unable to manage your diabetes on your own, have your advocate insist that a CDE supervise your treatment – they know the difference between the types. If you have a pump, make sure that no one touches it – again, your advocate needs to be on duty if you’re unconscious or unable to manage it on your own. Make sure your advocate knows how to operate the pump, and how to suspend it if you go low. Also make sure your advocate has a meter and glucose tabs, and doesn’t show them to anyone – I had one in the hospital, and they CONFISCATED it! You can’t depend on them to check your BG when you might need to, and you can’t depend on them to treat a low promptly (although lows tend to be rarer simply because you’re sick. But you never know)

Can you tell this is a hot-button issue for me?

I know the feeling! It is so frustrating, and makes me want to hit my head against the wall!

I am aware of the dangers of steroids and sometimes have to take them. Ditto antibiotics (and the thrush that that can cause if you are a diabetic!) but also, I have an added complication. I cannot take human insulins - only pork - and when they insist on putting me on a continuous insulin drip (human!!!) then I can go so badly hypo that it cannot go up! I was in hospital for a week and managed to hypo 42 times! I vaguely remember them sitting with a hypo box containing every known remedy - glucogel, hypo stop, you name it!

The accusation was that I was deliberately injecting extra insulin to cause these hypos (which were all extremely bad ones!) to gain attention! The next time I went into hospital I refused to let them put any kind of insulin in but insisted on doing my own treatments.
And when the doctor came round before the operation the nurse said in a very derogatory tone “Patient is refusing insulin” as if I had done something really terrible.

IDDT International which campaigns for patient choice, including the choice as to which insulins the patient wants has taken this kind of problem on board and brought out a “Diabetes Treatment Passport” so that the patient can write down specifically all the different symptoms of hypers and hypos, what you want done about it and what times you want your snacks and meals etc and anything else that you want to put in and nurses now HAVE to take these things into account and follow your guidelines!

For the nurse that told you that your blood sugars were to do with eating to much I would say that it is a well known fact that steroids cause high blood sugar levels, whether you eat or not! As do some antibiotics.

And the dentist should know that tooth problems are often caused by long term undiagnosed diabetes and yes, your blood sugars will go up if you are having an infection somewhere! What is the world coming to when so called professionals do not know about diabetes??? Grrrrrr!

Hear hear! And another thing. In the hospitals in UK they only cater for non-diabetics at breakfast time - jam or marmalade on toast! Why not vegemite, marmite or Bovril?

I always have take my own supplies of these in. AND an extra large mug for tea! Those little cups they give you in hospital would not be a mouthful for me when I want tea! No, I do not have a big mouth, just a tremendous thirst on!