What to Expect When You’re in the Hospital

Knowing what’s ahead can help your hospital stay run more smoothly

Because good communication is so important, Kristina Holleran, R.N. talks to patient Vienna Demarco of Kutztown about the diabetes care she will receive during her hospitalization.

High Blood Sugar and Illness: A Dangerous Combination

A recent study found that when people are hospitalized for a serious problem, whether it was surgery, illness, infection or heart attack, it is important to prevent and treat high blood sugar, says diabetes educator Joyce Najarian, R.N., director of Lehigh Valley Hospital’s Helwig Health and Diabetes Center. “Keeping blood sugar under good control can shorten your hospital stay and reduce your risk of infection, illness and even death.”

Here’s what high blood sugar can do—even in the short-term—that makes illnesses so dangerous:

• Impairs the ability of your white blood cells to fight off infection
• Affects your blood platelets, raising your risk of blood clots
• Can elevate blood pressure
• Impairs your body’s wound healing ability
• Can raise your risk of developing diabetic ketoacidosis if you have type 1 diabetes. “Ketoacidosis occurs when your body doesn’t have enough insulin to store the glucose in the cells for energy,” Najarian says. “Your body has to break down fat for energy, which can lead to acids in the blood. That can cause serious, and sometimes even fatal, complications.”

Education in the Hospital

If you’re hospitalized, your doctor may ask someone from the Helwig Health and Diabetes Center to offer you support. “For example, your doctor may call us if you’re new to insulin and have never monitored your blood sugar before,” says diabetes educator Joyce Najarian, R.N., the center’s director. “In that case, we could come to your hospital room and show you how to use your blood glucose meter.”

If you have diabetes, did you know you’re four times likely than someone without diabetes to be hospitalized? And because complications can involve your heart, kidney and nerves and cause your blood sugar to rise, you’re also likely to be hospitalized 30 percent longer than people without the disease.
What can you do to make your hospital stay less stressful? Have a clear picture of what lies ahead. Here’s what you need to know about a potential hospitalization.

• If you know you’ll be hospitalized or are scheduled for surgery, it’s important to bring your blood sugar under control beforehand to reduce your risk of complications, says Lehigh Valley Hospital and Health Network internist Marc Shalaby, M.D.
• Expect hospital staff to monitor your blood sugar more often than you do at home—perhaps four times a day. “We know you’ll get better faster if your sugar is under control, so we’ll follow it more closely,” says Shalaby.
• Don’t be surprised if your doctor puts you on insulin during your hospital stay, even if you’ve never taken it before. “Your body releases stress hormones when you’re sick, which can make your blood sugar rise,” says Shalaby. “The oral medications you’ve been taking at home may not be enough while you’re in the hospital, and you may need insulin for a while.
• You may be switched to a different type of insulin while you’re in the hospital because it may work better, or differently, while you’re under stress, eating differently and moving less, says diabetes educator Joyce Najarian, R.N., director of Lehigh Valley Hospital’s Helwig Health and Diabetes Center.
• Ask for an early-morning time slot if you know you'll be having surgery, Najarian says. “That will help you avoid prolonged fasting before surgery and keep your blood sugar under better control.”
• Don’t be concerned if you’re given intravenous (IV) insulin during your surgery and for 24 to 72 hours afterward. “If you need IV insulin to get good blood-sugar control, you’ll also need hourly finger sticks to monitor your blood-sugar levels,” says Najarian.
• If you have good blood-sugar control on the insulin pump, bring your supplies and plan to continue using it in the hospital. However, if you’re physically or emotionally unable to operate the pump, you could be put on IV insulin or insulin injections temporarily.

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