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Diabetes: Five ways to be active in your care at the hospital

American Association of Diabetes Educators www.diabeteseducator.org

American Diabetes Association www.diabetes.org

Juvenile Diabetes Research Foundation www.jdrf.org

The Joint Commission www.jointcommission.org

The Joint Commission is the largest health care accrediting body in the United States that promotes quality and safety.

Helping health care organizations help patients

Living with diabetes can make you good at managing the ups and downs of the disease. You can handle sick days, a trip to the store or a trip across the country. Going to the hospital, however, presents new challenges. Do not let your diabetes care take a back seat while you are in the hospital. You should always be an active participant in your care.

Before you go to the hospital, talk with your doctor or diabetes educator. If you have to go to the emergency room, make sure hospital staff know how to get in touch with your diabetes team. While in the hospital, ask a trusted family member or friend to be your advocate. An advocate can ask questions that you may not think about or be able to ask.

Here are five things that you can do to take care of your diabetes while you are in the hospital.

Diabetes: Five ways to be active in your care at the hospital is supported by

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The goal of the Speak Up™ program is to help patients and their advocates become more informed and involved in their health care.

Find out how your diabetes will be managed Do not assume that hospital nurses or other caregivers will know how to manage your diabetes. Your diabetes care team should work closely with them to help care for you. In addition:

q Do not be afraid to remind your caregivers that you have diabetes. q Always wear your diabetes ID. This tells hospital staff that you have diabetes. You may need to take it off for treatment or a test. Remember to put it back on. q Ask what changes will be made to your current diabetes care plan. q Ask how often and when your blood sugar will be checked. q If you take insulin at home, ask the doctor taking care of you in the hospital to write insulin orders. The nurses will follow these orders during your stay. q If you wear an insulin pump, ask if you can leave it on during your hospital stay. q Tell the nurse if you think you are having symptoms of low or high blood sugar.

Ask what will happen with your medicines People with diabetes can be affected by new medicines. Speak up if you have had any problems or reactions to medicines in the past. Also ask:

q Which medicines to stop taking before your hospital stay. q What medicines are being given to you each time and why. If you are forgetful, keep a log. Often, medicines are given twice or forgotten. q What to do if you are sick to your stomach or cannot keep medicine down. Your doctor may need to make changes in your diabetes medicines. q What to do if medicines are not given on time or before your meal. Do not let anyone give you rapid acting insulin if your meal has not arrived. q If you have surgery, will your blood sugar be affected by the medicines used to put you to sleep. q If your blood sugar will be affected by new medicines given to you after surgery or for your illness. q If you will be given insulin, ask what type you will be given and when. You may not normally take insulin, but you may be given it in the hospital.

Know what will happen with your diet Talk to the hospital dietitian about what you like to eat. You need to know:

q Will your food and meals be adjusted to help you achieve blood sugar levels in your target range. q What you should do if meals are not on time, if your blood sugar has not been checked, or your medicines do not arrive before your meal. q How your blood sugar will be managed if you cannot eat. q When you will be able to eat normal meals. q To alert the nurse if a visitor brings you food. You may need to have your insulin adjusted.

Avoid getting an infection People with diabetes have a higher risk of getting an infection while in the hospital. You should:

q Watch to see if caregivers wash their hands. Speak up if they do not. q Make sure caregivers wear clean gloves. Do not be afraid to remind them. q Tell your nurses about any cuts, sores or bruises that have not healed. q Remember to wash your own hands. q Ask sick relatives or friends to stay home until they feel better.

In addition, make sure you get a flu shot every year and that your pneumonia vaccine is still current.


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Find out what will happen when you go home Have your doctor explain what you can expect after leaving the hospital. Ask about the follow-up care that you will need. Make sure that you or your advocate understands the instructions. Find out:

q What will happen to your blood sugar while you are getting better. q The signs and symptoms of low and high blood sugar and how to treat them at home. q What signs and symptoms should cause you to call the doctor. q When you should see your doctor for follow-up care.

q If you are going home on insulin. If you do not usually take insulin, make sure you get instruction and show the nurse that you can give yourself an insulin shot. Ask how long you will need to take insulin at home. q If you have a wound, how long it will take for it to heal. Healing can take longer for people with diabetes.

q When you can go back to your normal exercise, medicines and diet.

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