Recent admission to hospital

that used to be quite a common story, but in the hospitals following the "Think Glucose" initiative it's getting better. Check if your hospital is signed in to this and complain via PALS whether they are or not. If they go on that way, they're going to kill someone, if they haven't already.
Hana

Sorry you had such a bad experience. Doesn't fill you with confidence, does it?!

I was in hospital recently for an operation. I was put on a sliding scale to control my sugars while I was in theatre. When I woke up from the anestethic I felt quite unwell. I put this down to the drugs and continued to sleep for most of the day. It got to the point where i felt so unwell that I had to call the nurse. I asked them to check my BM and it was ridiculously high - 28. I was fuming. They were supposed to be looking after me! I demanded they took me off the sliding scale and told them I would take care of my own injections. 

I complained to the surgeon and to PALS. Apart from the diabetes care the staff were great, but it seems like such an important thing to screw up! 

I'd strongly suggest you raise your concerns to the hospital. As for being better prepared next time - make sure you take your insulin with you so you can administer yourself. Tell each and every nurse/doctor that you meet that you are diabetic - don't rely on them checking your notes. Most importantly, control your diabetes and make sure you don't put yourself at risk of DKA again!

Emma

I'm on our local "Think Glucose "panel and I know that in our hospital they offer self medication to all insulin users. They are working towards offering it to tablet users too. They have to check each meter if the patient is self monitoring. It's not all that straightforward. They even have to get pen users onto syringes in case a nurse has to give the injection, when pens are a risk for "needle sicks". Neverh4teless, if the care isn't up to standard, you need to contact PALS.
Hana

Hana, the hospital I was admitted to is also part of the Think Glucose initiative. While a lot of the nurses were very clued up about diabetes, there were some that just had no idea. To give an example, when they had me on the sliding scale and my sugars reached the high 20s I had to ask the nurse to give me some more insulin (I'd had major surgery so was unable to reach my insulin pen to to this myself). I was told to wait until the drug round at 7am. This happened at 3.30am.

I think it's great that the think glucose initiatives are being introduced but they certainly don't seem to be implemented or practiced. Diabetes is a serious disease and there have been several people on this forum who have complained about poor care while they have been in hospital. There is a lot more that needs to be done.

Hi

Well, am a bit shocked to read all this. I haven't been in hospital for a few years now but when I was, my care was really quite good. Not that the nurses had to do a lot for me mind, as I was more than capable of looking after myself. However I have been on sliding scale before for an op and didn't do wonderfully well with it as the nurses had to keep on adjusting it all the time........... in the end they took it down and let me sort myself out once I was able to eat ok. Novorapid is not used in hospitals in sliding scale as far as I know. It's always Actrapid as it's cheaper and does more or less the same job.

Paranoid now as I may have to go in for a small op and I don't know enough.

1) what is a sliding scale - a pump? how does it calculate insulin doses? Do I get a choice for how my insulin is managed whilst I am unable to do it ?
2) why is a kwikpen anymore dangerous for needle stick?

Phrased that badly ... not worried so much as now aware of the scale of what I don't know.

Thanks for the heads up!

Mbudzi - with regards to the sliding scale, they insert a cannula into one of your veins. Two lines will be fed into this cannula. One with insulin, one a saline solution with glucose. Your sugars will be tested on a regular basis. The rate of insulin will then be adjusted according to your BMs. In my experience they prefer you to administer your own injections over using a sliding scale. Sliding scales tend to be used for DKA or if you are having a general anaesthetic and need to fast.

Make sure you take your own insulin with you and I would also recommend taking your own BM. You should have a pre op before your surgery to be sure to ask about your diabetes care then - each hospital will have a different approach.

Also make sure you take lucozades etc if you have to stay overnight.

Sorry if we've worried you! Wasn't my intention at all. I was just offloading. As soon as you're awake and able to inject they will take you off your sliding scale and you'll be fine. Might have to lower your doses as hospital food is pretty foul and you probably won't want to eat much lol. I've found that I've had to increase my long lasting insulin dosage by 6 units after surgery. Probably as I have been quite inactive since the op. Just something to bear in mind.

I hope your op goes well and it's nothing too serious.

Take care,
Emma

If you have done DAFNE/Know your insulin ratios then it is wise to discuss I have fund the most clued up/understanding people are the anesthetists/consultants but very often some of the nurses/JR Docs have no clue about Diabetes

Sorry to hear it!

Several times it seemed I was overlooked/forgotten by some whilst on the ward on diagnosis recently!

What were your ketones when you left?