Preparing for a Hospital Stay with Type 1 Diabetes
Managing Type 1 Diabetes in the Hospital
A hospital stay for a person living with type 1 diabetes (T1D) may present some unique challenges.
The key is to be well-informed, know what to expect, take an active role in managing your T1D while in the hospital, and (if possible) plan ahead.
Things to Pack
In addition to traditional items you would bring for a hospital stay (e.g., toiletries, a change of clothes, etc.), you should bring your personal diabetes supplies, including:
- Test strips
- Lancets
- Glucometer
- CGM
- Chargers for your diabetes devices
- Insulin (though many hospitals require you to use hospital-provided insulin)
- Insulin pump supplies
Be sure to bring extra of everything, just in case!
Visitors and Caregivers
Hospital protocols for visitors vary from hospital to hospital, but there are steps you can take to help enable a caregiver to assist with your diabetes management in the event you are hospitalized.
Talk with your endocrinologist and primary care provider to develop a plan before you need to go to the hospital. Know who to call prior to heading to the hospital and make your desires known about your care, particularly if you want a caregiver to assist with your care and be present during your hospitalization.
If hospital policies do not allow your caregiver to remain with you during your stay, you or your caregiver should ask how your caregiver can play an active role in helping to manage your diabetes.
If you are over 18, you should have an Advance Care Plan in place. This document will allow your medical team to communicate with your designated caregiver about your medical care.
Preparing for a Surgery or Procedure
If you are having a surgery or procedure done at the hospital, the most important thing is communication with your endocrinologist, the physician leading your procedure, and your care team. It is important to discuss the procedure with your endocrinologist in advance so that you can develop a plan to follow pre- and post-procedure. This plan should address:
- Managing fasting related to the procedure,
- Use of your diabetes devices (CGM, insulin pump, automated insulin delivery system) before and during the procedure,
- The expected duration of your hospital stay, and
- What to expect with the procedure, including any anticipated challenges with nausea, vomiting, or eating and the possible need for medications that impact glucose levels (especially steroids!).
Once you have your endocrinologist-approved plan, share it with the medical team involved in your upcoming procedure and/or hospital stay. Have a list of questions prepared and make sure they are aware of what accommodations need to be made for people with type 1 diabetes.
The team assigned to you in the hospital may know more about type 2 diabetes than they do about type 1 diabetes, and may not recognize that people with T1D need insulin to prevent ketones even when they are not eating. The team may also not be familiar with blood sugar management using continuous glucose monitoring, multiple daily insulin injections, insulin pumps, and/or automated insulin delivery systems.
It is vital that you mention that you have type 1 diabetes and have a medical identification bracelet prominently displayed. Make sure to tell the scheduling staff about your T1D to facilitate early morning scheduling to avoid prolonged fasting which may be more challenging to manage with T1D. Make sure that they make a note prominently in your chart that you have T1D.
If your blood sugar levels are consistently above or below target while you are in the hospital, don’t hesitate to ask for a consult from an endocrinologist.
During Surgery
While under anesthesia, the anesthesiologist will be in charge of monitoring your blood-sugar levels. No matter how short the procedure, you can ask that your blood sugar be measured throughout.
Any person with T1D should have an IV during surgical procedures–that way, if your blood sugar levels go low, they can administer IV dextrose (a form of sugar) to raise your blood sugar quickly. Inquire with the anesthesia team about whether they are willing to monitor your CGM and/or insulin pump and review basic aspects of use with them if they agree.
Post-Op
After a surgery or procedure, you and/or your medical team should keep a close watch on your blood sugar levels. Keeping your blood sugar in your target range is key for healing, but there are a number of common post-surgery factors that may make it more difficult, including having trouble eating, vomiting, elevated stress, reduced activity, pain or discomfort, and medications (especially steroids!).
Reach out to your diabetes care team and consult with your physician at the hospital where you are getting a procedure done so you can get answers to all your questions and ensure that you are staying on top of your T1D management.
Health Insurance Guide
Our type 1 diabetes health insurance guide helps you navigate prior authorizations for medications, denials, appeals, applying for an exception, and more.
