Diabetes Control Matters
When You Are In The Hospital
A variety of factors associated with hospitalization complicate
blood glucose control for patients with diabetes. Avoidance
of complications requires flexibility, planning and constant
surveillance. It is currently recommended that during any
hospitalization, the blood glucose values should not be allowed
to exceed 200mg/dl without treatment. Allowing blood glucose
to exceed this level increases the complexity of the admission
and places you at risk for additional medical consequences.
Poor long-term diabetes control is common in-patients who
are admitted to the hospital and easily identifiable through
examination and laboratory measurements of HbA1c levels. Hospitalization
may provide an "opportunity" to investigate the
problems leading to poor control and to develop a plan that
can be utilized and maintained after discharge.
Planning for discharge from the hospital should be initiated
early in the hospital stay and should include education in
diabetes survival skills for you and your family. After discharge,
you should be followed closely to ensure that your recovery
is progressing and that you have made a successful transition
to outpatient services for further education and follow-up
of your diabetes.
Why is it difficult to control blood glucose in the hospital?
- Stress
- Loss of appetite, nausea, or vomiting
- Altered diet
- Changes in timing of meals and injections
- Difficulty controlling timing or injections relative
to meals
- Procedures interrupting meals
- Intravenous fluids
- Added medications contributing to hyperglycemia
or adverse effects of hyperglycemia (ex. Steroids)
- Reduced signs and symptoms of hypoglycemia
- Lack of attention to required adjustments in
diabetes management.
- Multiple care givers who may not be familiar
with patients' usual regimens.
Potential Consequences of Uncontrolled Blood Glucose in the
Hospital
- Insulin resistance
- Increased risk of infection
- Poor wound healing
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