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Could preventing hypos in hospital reduce inpatient time?

DCUK NewsBot

Well-Known Member
People who experience hypoglycemia during a hospital stay typically spend a longer time in hospital, new research has found. A review of 15 international studies has shown that people with diabetes who develop hypoglycemia while in hospital, end up staying for an average of 4.1 days more than those who did not experience low blood glucose levels. The study also showed that mortality rates were nearly double in people with diabetes who experienced hypoglycemia in hospital compared with those that did not. The research raises the question of whether preventing hypoglycemia may help to reduce the length of hospital stays and whether it could reduce mortality rates. Lead author Andrea Lake, a diabetes nurse specialist at Cambridge University Hospitals, said: "It's really important that we understand the impact hypoglycemia can have on our inpatients' recovery. Our review found not only longer hospital stays for those exposed to hypoglycemia, but the risk of inpatient mortality almost doubled in this group. "Although it is impossible to tell from the studies reviewed whether a hypo is the cause of this increase or simply a marker of someone who is at greater risk, understanding the association means we can start to deal with it. "If we could reduce the chances of it happening in the first place that would be really beneficial for our patients. We need to be considering the risk factors for hypoglycemia, acting upon them and notifying the appropriate people." The studies used for the review involved hospitals from the UK, the USA, Spain, the Netherlands, Saudi Arabia, Singapore, Italy and Sweden. In a bid to prevent hypoglycemic episodes in hospital, the researchers have suggested patients should be encouraged to keep to their normal diabetes routine, using the equipment they are used to. The findings have been published in the journal.

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Cue NHS policy to feed diabetics [even more] sugar in hospital?
 
DCUK NewsBot said:
In a bid to prevent hypoglycemic episodes in hospital, the researchers have suggested patients should be encouraged to keep to their normal diabetes routine, using the equipment they are used to
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Not eating the carb laden meals they aren’t used to and not having their medication removed from them and rationed might help then!
 
HSSS said:
Not eating the carb laden meals they aren’t used to and not having their medication removed from them and rationed might help then!
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I was thinking similar. Surely if diabetics are having hypos in a hospital then it’s a reflection of misunderstanding and mistreatment by the attending staff? Of course, I understand it’s not a perfect world and mistakes will happen, but the language used here sounds suspiciously like patient blaming. Again.

Perhaps my journey of discovery has left me jaded with cynicism
 
My mum was in hospital recently and there was another lady with diabetes across the ward. The nurses had taken over her management completely and were arguing with family members about her insulin dosing.. sugars were all over the place from what I overheard.. seemed that the nurses arrogance combined with ignorance were very dangerous.
 
I have witnessed two patients having hypos in hospital. Neither of them were capable of administering their own insulin. Yet on both occasions (different hospitals) the nursing staff said ' what have you been doing?' to the patient.
 
HSSS said:
Not eating the carb laden meals they aren’t used to and not having their medication removed from them and rationed might help then!
Click to expand...

I agree in principle but the unfortunate fact is that MOST people with diabetes do eat 'carb laden' meals so they are very much used to them having had the eatwell plate tattooed on their foreheads.. You have to remember that the people on this site are in the minority when it comes to lower carb. In fact I would go so far as to say that the 'average' diabetic in hospital ends up eater fewer carbs than they are used to given the portion sizes are tiny.
 

Agreed, last time I was in hospital for a minor surgery I was lucky to be left to treating my condition as I felt needed. Just an over night stay for me, home next morning. I didn't get anything to eat even after surgery was done in the morning at all that day or night. I was given breakfast, which was weetbix, toast, jam, margarine, banana, whole milk, apple juice and a pudding of some description, nothing I'd consider eating. Luckily my wife brought in food I'd normally be able to eat that didn't require a huge amount of insulin to process. I did manage a few cups of coffee from the morning nurse who was also a keto eater, who described the food I was offered as something similar to what comes out the back end of a bull. So, had a good chat with her.... but hospital food is what it is. The treatment part of it, I was pretty lucky to be able to decide what to do.
 
Jim Lahey said:
Cue NHS policy to feed diabetics [even more] sugar in hospital?
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The article talks about reducing the chances of a hypo while in hospital, which sounds great, but my cynical side then thinks it's an excuse to keep levels even higher whilst in hospital, which could mean a change of protocol in how low levels will be aloud to get before shoveling in the glucose.
 
I get really annoyed at these studies because there is a simple answer if they really want to minimise hypos, catch them before they get to hypo stage....maybe by using a CGM?
 
Yeah i accept that, I pondered over how to word it and tried to cover the point with “that they aren’t used to”
 
Hospital's a dangerous place to be, seems to me, especially frightening is the loss of control over one's insulin management.
 
HSSS said:
Not eating the carb laden meals they aren’t used to and not having their medication removed from them and rationed might help then!
Click to expand...

Exactly this! I was in for monitoring for a few hours last month and was offered dinner, which I declined as I wasn’t risking my bloods going sky high from carb laden food I wouldn’t normally entertain as I was hell bent on not being kept in. Then I had a look at the menu for the next couple of days and there was pretty much nothing suitable, definitely nothing I could have had at breakfast, lunch was sandwiches/baked potatoes etc, everything was carb heavy. I was glad to get home to my home made soup.

Thankfully they didn’t even mention taking my insulin off me, if they had they would have had a fight on their hands. I know they are just doing their jobs, but you are not taking my lifeline from me.
 
zand said:
I have witnessed two patients having hypos in hospital. Neither of them were capable of administering their own insulin. Yet on both occasions (different hospitals) the nursing staff said ' what have you been doing?' to the patient.
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Wow. That's disgraceful.
My consultant told ward sister how to treat MY diabetes on the ward. She was worried but it went fantastically well. Well Done Sunderland NHS.
I managed my diabetes minus 1½days of pain and recovery from key-hole Roux-en-y.
I only stayed 3 nights and for the first and last day I managed myself.
A great success!
Shame my constultant has left for Dubai.
 
Type1s and other type patients at risk of Hypoglycaemic events should be treated individually. Even brittle diabetics.
End of.
No other comment to make.
 
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