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The Question
Sat Feb 01 19:48:36 EST 2014

Went into hospital and was given no insulin for meals. Hospital policy and it's wrong. What say you? Is this acceptable. You run HIGH for Hours.
Asked By: prez  

Background Info Hide
I am a Type 1 diabetic, and this puts me at risk for ketoacidosis. The hospital would not budge and they lied to me saying it was because some patients don't eat, or it's congress that sets the rules. They essentially blew me off and they lied to me. What can a diabetic do so they don't run sky high for hours? They also said they could not check my blood sugar for hours after I ate to correct a high. This puts my body in dangerous territory and complications down the road. This hospital policy makes it easy on the nurses but is dangerous for a diabetic. I have not seen this question asked and since I have left the hospital, I have received two calls thanking me for bringing this dangerous policy into the light. Could you help me to stop this insane practice?
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Expert Answers (1)
2014-01-31 20:03:05.0

Hello,

Thanks for asking dLife.

Managing blood glucose in hospitals can be challenging for both patient and facility. The use of insulin therapy to attain targeted blood glucose control is often subject to practice variability, leading to suboptimal blood glucose outcomes.

I am rather puzzled by your hospital experience. According to the Society of Hospital Medicine, insulin is the treatment of choice for hyperglycemia (high blood sugar) in the hospital. Insulin can be administered by injection or as an intravenous infusion (IV) for cases in which rapid titration is the goal. Uncontrolled hyperglycemia is no longer the accepted standard of care for hospitalized patients.

Check out this article on managing diabetes in the hospital.

Take care.

Answered By: Liz Quintana
Accreditations: EdD, RD, LD, CDE
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Community Answers (7)
2014-04-30 09:07:45.0

It seems I have been very lucky. I seem to find myself in the hospital about once a year for various reasons. I have always insisted on administering my insulin myself. All the hospitals needed to do that was to get a permission from my primary. After that, the nurses just recorded my BG numbers and how much insulin I had used.
Answered By: jennifer132

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2014-02-28 20:29:09.0

I was recently in the local hospital for a stroke. The emergency room doctor wrote an order for all my insulin to be administered at 11PM at night, both lantus and the novalog! Was very perturbing to me, a T-1 for over 50 years. I asked to be discharged ASAP. I wished diabetes on the Dr. and all the fools that write up procedures in that hospital. If I had been unconscious all that insulin at once would have killed me!
Answered By: alanbcote

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2014-02-28 16:11:23.0

The Doctor who diagnosed my diabetes was himself a diabetic. He told me that if I were to die as a direct result of either a sugar high or low the odds were very high that it would be by a doctor while I was in a hospital. He insisted that each diabetic was different and my wife and I needed to learn my diabetic reactions to different foods and medicine. If I were hospitalize we were not to allow anyone to care for my diabetes but her or me. I shared this with my cousin who was also a diabetic. While in the hospital she was given an insulin shot by a Dr. because her blood level was 128 . She did not take insulin. It took three days for her blood sugar level to come under control. So maybe it is not bad if they don't treat your diabetes but someone besides you has to understand your personal condition.
Answered By: dunigan

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2014-02-28 15:49:29.0

You aren't the only one - I was admitted to Fairfax (VA) Inova Hospital last spring and the young MD on duty at night (I think a resident) refused to give me insulin before a meal despite having a blood sugar reading of 182 on the grounds that I had already had 20 units that day which was all that was allowed under the hospital protocol! (I regularly take 40 units of Lantos three times a day as well as 30 mg of Actos and 2000 mg of Metaformin - they wouldn't give me Actos either!) and said that the 182 reading before dinner was :"normal" as far as she was concerned! As a result I was afraid to eat the dinner., She also refused my request to call a supervising physician stating that they were too busy. When I told my doctor in the morning when he visited he apologized and said that he had no control of hospital policy -- he had me released earlier than I should have been just so my diabetes could be regulated. This type of hospital should be penalized for such actions but they never are!!!!!!! How can we bring about changes to hospitals with such physicians and such "protocols" ????????
Answered By: pmb2pmb

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2014-02-28 14:19:25.0

I must live in a very enlightened community. I had surgery in Oct, 2012 and, knowing I was T2, they checked my glucose before the surgery, immediately after leaving recovery, and twice during the evening. When I asked if I had needed insulin, would they administer it and the answer was a qualified yes. Qualified only upon my PPC's approval and, since he monitors my health really well, there would have been no problem. I'm scheduled for surgery again in April at a different hospital but it's one that is managed by the same group my doctor is in. This means they have complete access to all my records including my A1c tests. There will be no problem if insulin is needed but, with this question in mind, you can be sure I'll double check during the pre-surgical appointment. Thanks for the info.
Answered By: rubybenubi

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2014-02-28 10:03:58.0

I have had type 1 diabetes for 25 years. I also have epilepsy. Due to my epilepsy I was unconscious for 2 days in the hospital. When I woke up the nurses were telling me my blood sugar had been 300+ for 2 days. I told them the insulin I would need to bring it down. They told me no. The staff did not seem to care about my high blood sugar. The reason it was high was because I experience Dawn Phenomenon. I require 10 units of Humalog every morning I wake up. Does not matter if I eat or not I have to have 10 units of Humalog. Every hospital and all my doctors in area now know that in my records. I HAD TO LEAVE THE HOSPITAL THAT DAY. When I got home it took me 3 hours to get sugar down to normal. Something the hospital could not do for 2 days.
Answered By: gonzojoe

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2014-02-04 15:02:32.0

I have seen the exact same thing when my friend was in the hospital. type1 for over 50yrs. this hospital was in dyer Indiana. the nurse wouold ONLY check her pre-meal sugar. I questioned this. she said it was policy & the reasoning was as long as it was back to normal before the meal,. everything was fine. she even had a child or grandchild with diabetes & knew how STUPID this was.
Answered By: lmnohos

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