Information you need to know during your hospital stay
When a person with diabetes is admitted to hospital, many factors can cause blood glucose levels to fluctuate: stress, different meals, drug treatments with the illness itself and reduced activity levels all influencing the blood glucose levels.
This leaflet aims to provide you with information on what to expect during your hospital stay. If you are admitted to hospital, it is important that you discuss and agree a plan of care with the staff relating to your diabetes.
This will guide you on the level of care you should expect to receive, and how to manage your diabetes whether you are admitted for a planned procedure, operation or because of an emergency.
Before your stay
If you’re having a planned operation or procedure, the pre-operative assessment nurse will agree a plan with you. This should include information on what you should do before, during and after the procedure to keep better control of your diabetes. This may involve your insulin dose being changed during bowel preparation or stopping Metformin 24 hours before and 48 hours post procedure if contrast dye is required.
If possible, try to bring in all your supplies with you, including your medicines (all tablets and insulin), insulin passport, your insulin pen devices and your preferred snacks.
During your stay
Your diabetes needs will be assessed during admission and an individual care plan made. A capillary blood glucose test and a HbA1c (if not done within 3 months) are part of this initial assessment. Your feet will be examined for any wounds or abnormalities and a referral to the Diabetes Foot Multidisciplinary Team made if required.
The ward staff will use the Think Glucose Assessment and Referral Form to guide them in making referrals to the Diabetes Specialist Nurses (DSN). If your diabetes is well-controlled, you may not need to have this input. You can request a referral to the Diabetes Specialist Nurses if you would like further diabetes education or information.
We endeavour to provide a high quality of care to our patients. Please do not hesitate to inform and ask staff for help. The following may help us deliver good care.
- Inform staff of the timings and doses of your diabetes treatment. If meals, medications or insulin treatments do not arrive at the appropriate times, alert the nurse. Staff are aware that they need to give your medicines / treatment at the right times. (Although some emergency situations can cause delays.)
- Inform staff if you would like to manage your own diabetes or involve your carer / relative. You will be supported in your decision, unless this has been assessed as impractical. Self-management helps you to get medications, especially insulin, at the right time.
- Monitoring of blood glucose levels in hospital is often more frequent than at home. Remember to inform hospital staff of your usual range of blood glucose levels and what you consider to be low. Make staff aware of your symptoms when having a high or low blood sugar and how you would usually manage them at home. An information sheet on how to manage hypoglycaemia is available; just ask the diabetes specialist nurses (DSN).
- Target blood glucose levels should be agreed between you and the medical team. Changes in diabetes medication, is often needed whilst an inpatient and maintaining good blood glucose control is important to help recovery from your illness or operation.
- Please make staff aware of any specific dietary needs you have. All our main meals are suitable for patients with diabetes. If you carbohydrate count, there is information available, this is kept in the ward’s nutrition folder, so please ask the staff. It provides specific details on what our hospital food contains in terms of carbohydrate portions.
- Tell hospital staff if you usually have an additional supper or snack after evening meal so that arrangements can be made. You can also have food brought from home if you prefer.
- If you have an insulin pump we have an insulin pump nurse, who can be contacted on Ext: 2275.
After your stay
- Information about your diabetes medications will be included in the discharge letter to your general practitioner. A copy of this letter will be given to you. Your latest blood results, such as HbA1c, will also be included in your discharge letter. This will give your GP an update on your diabetes management.
- If your insulin has been changed or you’ve been started on insulin during your hospital stay, this will also be written on your insulin passport.
- You may need to carefully monitor your blood glucose level after your discharge. The medical team who looked after you during your stay will decide if you need a follow up with our Outpatient Diabetes team. This decision is documented at the end of your discharge letter.
- If you need further help with your blood glucose, for example if you needed to start insulin during your admission your medical team may refer you to our diabetes nurse led post discharge clinic, which is held on Monday afternoons in Stephanie Marks Centre.
- The Hospital Diabetes Specialist Nurses (DSN) will hand over your care to the community DSNs or District Nurses if you need further assistance.
- Both the inpatient DSNs and the community DSNs can give you information about education courses for people with diabetes. There are currently two education programmes, STEPH for people with Type 1 diabetes and X-PERT for people with Type 2 diabetes.
It is important to try to discuss your concern or complaint with those providing your care. Your feedback is important to us in order to improve our service.
Inform the ward manager or anyone in-charge of the shift that day. If this does not resolve the problem, contact the hospital Patient Advice and Liaison Service (PALS) at: 01932 723553.