Having to go into the hospital, whether it’s planned or an emergency, can be a stressful and uncomfortable experience. The key is to be well-informed, know what to expect, take an active role in managing your type 1 diabetes (T1D) while in the hospital, and plan well before your hospital stay.
How to Prepare
In case you are getting a surgical procedure done at the hospital, how do you plan for your hospital stay? The most important thing is communication, with your endocrinologist (endo), the physician leading your procedure and your care team. From your endo you can get a plan to follow pre- and post-op. Because fasting is often required before surgery, it’s important to plan accordingly.
Once you have your endo-approved plan, share it with the medical team involved in your upcoming hospital stay. Have a list of questions prepared and make sure they are aware of what accommodations need to be made for people with type 1 diabetes. The team assigned to you in the hospital may know more about type 2 diabetes than they do about type 1 diabetes and may not grasp the full dynamics of blood sugar control using multiple insulin injections or continuous infusion via insulin pump. It is vital that you mention that you have type 1 diabetes and have a medical identification bracelet prominently displayed. You need to tell the scheduling staff (so if you are having a procedure you get in early am due to fasting requirements) and the admitting staff. Make sure that they make a note prominently in your chart that you have T1D.
Don’t hesitate to ask for a consult from an endocrinologist if your blood sugar levels are not well controlled while you are in the hospital.
Here are a few additional elements that should be kept in mind in your plan:
Things to Pack
In addition to traditional items you would bring to the hospital for surgery (e.g. toiletries, a change of clothes, etc.), you should bring your personal diabetes supplies, including syringes, test strips, lancets, insulin and pump supplies.
While under anesthesia, the anesthesiologist will be in charge of taking blood sugar level readings. No matter how short the procedure, you can ask that your blood sugar be taken throughout. Any person with type 1 diabetes should have an IV during surgical procedures–that way, if your blood sugar levels go low, they can administer IV dextrose (a form of sugar) to raise your blood sugar quickly.
You and/or your medical team should keep a close watch on your blood sugar levels. Tight management of keeping your blood sugar in your target range is key for healing, but there are a number of common post-surgery factors that may make it more difficult, including having trouble eating, vomiting, elevated stress, reduced activity, pain or discomfort and medications.
Reach out to your diabetes care team and consult with your physician at the hospital where you are getting a procedure done so you get answers to all your questions and make sure that you are staying on top of your T1D management.