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Family Health Magazine
DIABETES

Home from the Hospital
Questions to ask before you leave

No one likes being in the hospital. Most people try their best to avoid a stay there. Still, those with diabetes may be hospitalized for a variety of reasons. Older adults with diabetes are 70 per cent more likely to be hospitalized than the general population. Most often, the time spent in hospital is related to complications of diabetes. These include cardiovascular disease (leading to heart problems or stroke), problems with blood circulation, infected wounds, amputations, kidney disease, or eye disease.

Managing diabetes well means continuously juggling food intake with activities and exercise. It also means checking blood glucose levels and talking to a doctor or diabetes educator when your levels are off. Blood glucose levels that are too high or low can mean a trip to the emergency room.

For those with type 1 diabetes, extremely high blood glucose levels may bring on diabetic ketoacidosis. This is a life-threatening condition in which the body burns fat for energy. Extremely low blood glucose levels (hypoglycemia) can lead to loss of consciousness or seizures. Avoid either extreme by being aware of symptoms of high and low blood glucose levels, by testing levels regularly, and by taking medications exactly as prescribed.

If you must stay in the hospital, the following tips may help you to get (and hopefully stay) out.

Ask Questions

• What signs and symptoms can you watch for to help recognize the problem that brought you into the hospital?
• How are your blood glucose levels?
• What is your blood pressure?
• What are your cholesterol levels?
• Can you use a logbook to record your levels and test results?
• Were any changes made to your medications or insulin while in hospital?
• If a new medication has been added, does it replace or should it be taken in addition to the medications you were taking prior to hospitalization?
• What is the dosage of your medications? How many times per day should you take them?
• Are your medications or insulin to be taken with or before meals?
• What side effects of your medications or warning signs mean you should contact your health care team?
• Have your blood glucose or blood pressure goals changed? What is the plan for how you are to treat high and low blood glucose levels?

Be aware of resources that are available to you

• Consider talking to a pharmacist educator.
• Ask if written information is available for you to take home.
• Think about whether you can update your blood glucose monitoring skills.
• Get help so that you are comfortable with giving yourself insulin injections.
• Ask if you and family members can meet with the in-hospital diabetes educator.
• Consider having the transition services co-ordinator (home care) meet with you and family members to discuss your needs once you are back in the community.
• Ask for a referral to the Diabetes Education Centre, so you can see a nurse and dietitian after discharge.
• Plan to meet with your family doctor.
• Consider speaking to a social worker if you have concerns about financial resources to cover your medical needs.

Be actively involved

• Practice testing your blood glucose levels in the hospital, especially if your skills need a refresher.
• Do your own injections with insulin pens or syringes to make sure you are comfortable with the technique.
• Record your blood glucose levels and readings from other tests in your logbook.
• Keep menu slips from your food trays for meal ideas.
• Know where to get the best service in the community when buying diabetes supplies such as testing strips or syringes.
• Have a list of phone numbers you can use after discharge. The list might include your doctor, the Diabetes Education Centre, or home care.
• Ask for a printout of your current medications. Take it to your community pharmacy so they have an update listing any changes that were made.
• Once you are home, keep a food diary for two weeks if you plan to talk to a dietitian about nutrition.

By preparing in advance, you should feel confident to leave when you are finally discharged from hospital. Many studies have shown that those who are actively involved in their own care recover faster. With your input, your care can be tailored to meet your individual needs. Good luck and stay well!