Had a minor procedure done under anesthesia at the hospital earlier today (nothing to do with D). I had been fasting, and therefore taking no insulin since lunch yesterday-- as I take no long acting, this is no big deal for me. I tested my fasting glucose level this morning-- 97-- perfect. The prep nurse recorded this number in my chart. Upon waking up after the procedure (4 hours after the fasting test, without any food or insulin since), the recovery nurse was telling me I needed to have a milkshake right away becasue my glucose levels were low. I was still groggy and had no idea what she was talking about. Had they tested me while I was under? How could I possibly be low? Luckily my wife, a nurse, was right there with me. No-- they had not tested me. No, I was not low.
Apparantly the hospital nurse thought that because my fasting level was 97, 4 hours prior, the first order of business upon waking was to slam a milkshake down a type 1 diabetics throat without any bolus.
I'm glad I immediately realized how ridiculous this was and of course didn't eat anything at that time-- but what if I had been a little kid or an older person who wan't thinking as fast as they used to? Pretty ridiculous.
Went home and tested at 110 before bolusing and eating. I didn't opt for the milkshake.
Does anyone else have comparable observations?
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Permalink Reply by christy on November 30, 2012 at 9:30pm I'm a nightmare patient lol being that I work in healthcare, I let them know right up from I'm a nurse. LOL so don't argue with me, I'm a nurse PLUS diabetic for close to 30 years. But all joking aside our hospitals here and our doctors/nurses are really pretty good about checking blood glucose levels frequently, and our doctors really get on them for letting blood glucose levels get high.
I've never had any problems with being in the hospital if I didn't have my meter, paging the nurse and saying I feel a little low, and her TESTING my blood glucose levels BEFORE treating, and they've always been really good with what can I get you. And testing pretty frequently to make sure you are coming up and IF I felt I needed additional (soda, juice whatever being able to get it, but as long as I was making sense, and coherent and not symptomatic and about to pass out, they've always let me be in control. Maybe like I said, it helps since I am a nurse, but I've seen working in the hospitals other diabetic patients, where its test and treat, not just blindly dump a bunch of glucose down someone, esp if they aren't symptomatic and making sense.
Permalink Reply by PedsRN on December 1, 2012 at 7:12am My story is your story christy. Right out of the box," I'm a nurse, T1 for 29 years and don't you dare touch my pump while I'm under anesethia". I find that hospital inpatient providers know little about current T1 management, but for the most part let me or my husband run the show as far as testing, bolusing, etc...
I find the lack of knowledge of the bedside nurse scary, but I blame that partially on the movement of taking basic diabetes care away from the bedside to the outpatient area, but also to the "dumbing down" of the bedside nurse, in order to prevent medical errors.
Permalink Reply by christy on December 1, 2012 at 8:45am I agree I mean when I was diagnosed I was in the hospital for at least a week, maybe even a little longer. Of course this was like 1984ish. And you had a specially trained diabetes nurse at the bedside, it was hours of diabetes education, etc. Now you are diagnosed and as long as your are not DKA, its like here's a bottle of insulin, here's a syringe figure it out. It really is scary and I think that is one reason, so many newly diagnosed diabetics are just stumbling around in the dark. I mean Im not saying after a week I knew EVERYTHING, but I was confident even at 10 years old of what I needed to do.

Permalink Reply by Gerri on December 1, 2012 at 2:47am A milkshake! I've found medical staff to be phobic about lows, for which they could be liable, & not concerned about highs.
When hospitalized with DKA, I was reprimanded for not eating starch laden meals. Somehow pancakes, French toast, grilled cheese sandwiches on thick Texas toast, mashed potatoes, corn & spaghetti were considered diabetic meals because dessert was sugar-free pudding. Get me outta here before they kill me.
A big risk, as Terry mentioned, of being injected with dextrose when admitted to the ER on the assumption diabetics are there for hypogylcemia.
Permalink Reply by Brian (bsc) on December 1, 2012 at 4:56am Does anyone know what the third leading cause of death is in the US?
Doctors.
As reported in the Journal of the Medical Association (JAMA),the deaths caused by the diagnosis, manner and treatment of doctors "constitutes the third leading cause of death in the United States, after deaths from heart disease and cancer."
We depend on healthcare professionals, they can really help improve our health and quality of life, but we should never blindly just trust them.
Permalink Reply by meee on December 1, 2012 at 11:59am you really need to be your own doctor these days... have your family with you and have access to the internet to look things up to keep tabs on them..
Yes you were fortunate that your wife waa present. I my experiences (too many mostly D related) I found it necessary to discuss the level of awareness of ALL staff theen make sure that I knew what was going on or who was going to oversee my care. Always check the hospitals insulin to carb ration as well as the blood sugar level adjustment procedure.
You may be interested in this from e-Patient Dave - great web site for patient information. http://epatientdave.com/
http://www.hospitalsafetyscore.org/
Permalink Reply by MyBustedPancreas on December 1, 2012 at 11:20am Ugh, this is one of those things that scares me the most - being in a situation where I can't make decisions for myself and having to rely on incompetent hospital personnel. In my experience, hospitals are all skewed to dealing with T2s, and most of the professionals I've encountered in hospitals don't have a clue about T1 and the management it entails. I think there needs to not only be more education within hospitals, but also more of a culture where the patient who lives with the disease 24/7 is listened to. That's what bugs me the most - when they don't listen!
Permalink Reply by meee on December 1, 2012 at 11:51am lol.. I'm glad you resisted the milkshake, fortunately your wife was there...
my experience was on my second hospital stay, one day after I was released from the icu, I was told after spending the day in the er and not eating all day that I one- was not going to be given dinner and two- was not going to be given insulin bolus for meals unless my bg was above 140!! This resulted in a big argument which resulted in me being allowed to use my own insulin for bolus and do my own testing- they did my basal doses. I don't think my nurse or anyone there obviously had very much knowledge about D. They just treat everyone the same and allow bg which are way too high obviously... they also gave me some meals which were total carbs before I started selecting them.. they did that my last day in the icu also, my first solid meal was a piece of french toast with syrup, lol.
In an Er where I stayed overnight after that, they came to tell me several hours after my bg tested at 60 according to their from the vein tests, that I needed to drink some juice because my bg was low... lol. I explained that I was testing it myself and it was fine and it was bit late to give me some juice.
Permalink Reply by Cinderfella on December 1, 2012 at 2:42pm
Permalink Reply by lotsofshots on December 1, 2012 at 2:55pm I was in the hospital for two days recently. I am a type 1 on MDI and take Lantus and Novolog. While I was there, the hospital would only give me the Lantus and no bolus for any meals. I was angry, but didn't want to argue. I was supposed to call a nurse and be walked to the bathroom or helped around when I got up, but every time they brought my food, I unhooked all my tubes and went into the bathroom and gave myself a shot of my own fast acting insulin that I had brought with me in my purse. They only tested my BG morning and night, so I checked it myself often, and did corrections when necessary as well.
Needless to say, I find it disturbing to go to a hospital, which is supposed to be a place of healing, and have health professionals treat diabetes like that. I think it sucks.
Permalink Reply by meee on December 1, 2012 at 7:52pm I agree, it's really a joke that many hospitals give this shoddy treatment... I think you need to speak up and argue with them if that happens again, you shouldn't have to be removing tubes etc. in order to get the treatment you need to stay alive and healthy!
Manny Hernandez(Co-Founder, Editor, has LADA)
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