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Management of diabetes in hospital

February 18, 2014 by Imagine_David 7 Comments

With a safe and effective diabetes self management plan you can reduce your risk of the need for a hospital admission.

However, if you do end up in a hospital bed – and it may not be for diabetes – ask to see one of the diabetes team.

Having the diabetes team in your corner is likely to reduce your time in hospital. Hospital admissions can sometimes be prolonged due to diabetes inadequately managed by non-expert health care professionals.

Consider:

Request a Copy of the Hospitals Policy Brochure “Your Rights and Responsibilities”

Managing hypoglycaemia and hyperglycaemia

You can request to see the hospital’s policies for the management of hypo and hyperglycaemia. Ask the treating team of doctors and nurses how this policy will be carried out as a part of your hospital care plan.

Request that you be able to access your own treatments to manage a hypo. If this becomes a problem ask to speak to the nurse in charge of your ward, or one of the doctors on your treating team.

If you are well enough, able to make decisions as usual, request that you be able to adjust your own insulin whilst in hospital. Ask the treating team to prescribe your insulin doses in a manner that allows for this. Ideally you will have some written plan from your endocrinologist for this situation.

Following an episode of either hypo or hyper ask the policy for how often to measure your Blood Glucose Level.

Blood glucose monitoring, including self monitoring blood glucose

Responsibility for monitoring can be shared between you and your hospital team

Request that, if you are well enough, you measure your own BGL’s in a timely manner to aid a rapid recovery. I’m sure there are some people with type 1 diabetes who have had their fingers unnecessarily hurt every hour by huge single use lancets in a hospital setting.

The approach to monitoring should be agreed and recorded in your hospital care plan. You should have access to your own blood glucose monitoring and quality control equipment.

If you are self-monitoring you may be asked to record your levels on a blood glucose chart(s)

The range and level of your blood glucose levels should be discussed and agreed with you in partnership with the hospital and diabetes specialist teams and recorded in your care plan. Sometimes this range may vary to your usual targets.

Your medications and treatments

If you wish to use your own medications during your hospital stay this should have been agreed and recorded in your care plan. If you are not able to use your own medications your hospital team should ensure that your medications are given to you at the appropriate times.

Unless impractical, ask to be given the opportunity to check that the medications on the prescription chart are correct.

Changes to your diabetes treatments

Not all people will experience a change to their diabetes treatments during their hospital stay. However there may be occasions where a change to your diabetes treatment(s) is required in order to better stabilise your diabetes control. If your treatment is being adjusted, especially if your insulin type is being changed by doctors who are not diabetes specialists, ask what their rationale is, for example

If you are normally treated with tablets, you may find that you are given insulin.

If you are usually on a mixed insulin and it is being changed to individual doses 4 times a day or

If you are normally on individual doses and it is being changed to mixed insulin twice a day or

Your overnight insulin is being changed or that you are given a glucose/insulin drip into a vein.

Access to food and food timings

Wherever possible, you should be able to make your own food choices

Whether this be from the hospital menu, the hospital canteen, or food brought in to your by relatives or friends

Ask to see a dietitian wherever possible.

Check what times meals are, and if an evening snack is gong to be provided to reduce your risk of overnight hypos. (one of the most common causes of overnight hypos in hospital is an evening snack served with dinner)

Depending on the nature of your stay (eg post surgery), a hospital dietitian may need to specify your dietary requirements. You may need some short term changes to aid healing etc.

Ask a family member or friend to advocate for you if you are unable to do this yourself

ASK QUESTIONS – ITS YOUR RIGHT

If you have something to share regarding self management of your diabetes from personal experience, please share. Tips on what worked (or didn’t work) for you etc.

Travel Safely, David – Diabetes Educator @ Diabetes Counselling Online

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#Control: to Major Tom: take your protein pills & put your helmet on..

February 13, 2014 by helwild 2 Comments

Control: as diabetics this is a word that can rule our every waking minute. It can be the word our health care professional(s) use to ‘scare’ us into ‘compliance. It can be the grinding slog that makes us feel, “When do I get a break!”

If we do let go of ‘control’, even for a day, we can feel as though every dire prediction that has ever been pointed our way will immediately come crashing down on us. All those fears that we hold inside, or that spill out if we ever get the chance to share with someone who ‘gets’ us, will come to pass if we just for even a short time ‘take our eyes off the ball’.

Yes, micro management of our diabetes is useful in managing our overall health. Yet there are times when it’s actually OK to let our BGL run a little high for half a day, or even a day. If we’re not pregnant, & we plan to do some vigorous exercise, it even makes sense to! It’s also OK to eat occasionally as though we do not have diabetes, although personally I prefer to eat the healthy foods that are also beneficial for ‘control’ of my type 2 diabetes! LOL! I am not a ‘jar of Nutella’ kind of girl. But I do enjoy the occasional Morning coffee treat, or lush dessert.

As the Mum of a teen with Type 1 diabetes, I had to learn to let go of Control. Not that I ever really had it, it was always my illusion, monitoring what was visible to me, managing my responsibility to buy & prepare food for the whole family. I know now that my teen made up logbooks of bgl’s, ate food away from home that I would not have ‘approved’, & didn’t always inject insulin nor check bgl’s when the HCP’s had instructed her to. Life got in the way. Yet she is doing just fine now, & I’m glad that she ‘normalised’ her adolescence to some extent. Why should we miss out totally on life’s rich tapestry because of a health condition?

Being truly ‘in control’ means being in charge of our own life, being in the Drivers’ seat: & ALSO that diabetes is not front & centre in our every waking moment. There are other things in life that are more interesting, more enjoyable, more beneficial. How can we reach that stage, which in a way is part of ‘acceptance’? It can be as simple as setting up routines that work for us, & following them in a way that is comfortable with our lifestyle. That might include having our Health Care team appointments slotted in & sorted for the year, rather than having a constant nagging thought that ‘I must make that appointment’. In getting groceries home delivered, instead of takeaway meals. In storing & managing our insulin, test strips, oral medications so that we never run out or have any go ‘out of date’. Importantly though, in ‘not sweating the small stuff’,& in not regretting decisions & behaviours that are in the past & can’t be undone. No shame, no Guilt.

happiness comes from letting go of guilt

Remember that as David Bowie sang “Planet Earth is Blue & There’s nothing I can do”

If you prefer Life with a strong dose of Reality, check out this more recent video version of Major Tom.Humanity can soar, you don’t have to give up your shot at the Moon just because you have diabetes. Happiness, a good life, smelling the roses. Enjoy the journey, & Open up the Sky- I know we’ll be just fine..when we Learn to Love the ride.

Helen Wilde

Helen is a long term Senior Counsellor with Diabetes Counselling Online, Teacher, mother of a Type 1 diabetic since 1979, Type 2 herself since 2001. Talking with one of our team may help you to work out whether your focus on control represents your fear & help you to learn strategies for letting go of some of that fear.

Try this link: http://www.diabetescounselling.com.au/counselling-request/

Helen is a long term Senior Counsellor with Diabetes Counselling Online, Teacher, mother of a type 1 diabetic for 34 years and a type 2 diabetic herself for 12 years.Talking with one of our team may help you work out what your barriers are and how to develop a plan of action to work through, over or under the barriers! – See more at: http://www.diabetescounselling.com.au/diabetes-and-weight-management/the-way-you-move/#sthash.77Hq1QSm.dpuf

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It’s all in your p.o.v..changing perspectives

January 16, 2014 by helwild 5 Comments

Today is likely to be one of the hottest days on record in Adelaide. It is also going to be the hottest day of any city in the world today, according to the forecasters. How do people handle something like this?

The answer lies largely in how people are situated, and what their outlook on life is.

My neighbours, who are a group of single men living in a Share House with a couple of bedroom airconditioners, were out early this morning polishing the old Mercedes when I went for my ‘diabetes stroll’. We exchanged a few words re the weather, and one of them said, ‘We’re off to Africa, it’s cooler there! Want to come with us?” Here is my mental image of what my day would look like if I’d accepted..

The Adelaide City Council has opened the air conditioned city bus shelter 24 hours all week, & invited the homeless to sleep there. They are providing free cold water. The Charities are working hard too, free lunch & a movie every day. And some of the homeless are cheerfully heading to the free Libraries after the movie, so they can stay in the a/c there. The city is doing its best to look after the less fortunate. I saw a homeless man last night on the TV news being interviewed- he was remarkably cheerful, optimistic, & resilient in his outlook.

Throughout the State, Volunteers are donning fireproof clothing, or volunteering to provide drinks & food for firefighters. With a number of firefronts to manage, people are managing on minimal sleep & in appalling conditions to ‘serve & protect’ the lives & property of strangers. How do they keep it up?

In their personal lives, people are offering help to family, friends & strangers. They are providing shade & water for wild birds & animals, sharing taxis with strangers & space in their homes for neighbours without a/c. They are calling elderly relatives with reminders to ‘keep cool, keep drinking’. They are voluntarily using less electricity in their homes by cooling only necessary areas, in order to avoid the dreaded ‘load shedding’ that threatens.

I have been thinking about this today in the context of the Global online diabetes community. More and more I am seeing the support given to other ‘people with diabetes’: by strangers to each other, simply because we share a common bond: we have diabetes, or we are caring for someone with diabetes- or both. Because it’s one thing to be a caring Health professional, & very important too. And it’s another thing to be able to ‘speak with’ and be heard by ‘someone like me’- someone who is also living this Diabetic life, every single day. Some of this occurs on Twitter, with many Diabetes related online communities. Others are comfortable on ‘bookface’, & we have special interest groups which you may find helpful yourself. Some are Open groups, you can simply join. Others are ‘closed’: that is for the protection of its members, who feel comfortable sharing worries & advice with others who are similarly placed with respect to diabetes. With the ‘closed’ groups, you can request to join, and a group Admin wil review your public profile, & possibly send you a clarifying question by PM.

Here are some of them:

diabetes.counselling

MenWithDiabetes

pregnancyparentingdiabetes

diabetesandfood

parents

diabetesweightmatters ; ruraldiabetes/

You may be just the person who is needed in a Group: your perspective on your diabetes might be just what someone else needs to hear: we are all different, & we are all the same. No matter what type of diabetes you have, or how long you have had it, in this century, in the times we live in, we Diabetics have never been more connected with each other. We can give and find support like no one before us in the History of the World has been able to.

” All of us are human beings first. We are all sons, daughters, mothers, fathers, brothers, sisters, grandparents, aunts and uncles, friends and lovers. We all laugh, cry, get angry, sad; worry and wonder what life is all about.

Then, we are people living with diabetes” Helen Edwards

All of us are human beings first. We are sons, daughters, mothers, fathers, bothers, sisters, grandparents, aunts and uncles, friends and lovers. We all laugh, cry, get angry, sad, worry and wonder what life is all about. – See more at: http://www.diabetescounselling.com.au/uncategorized/people-politics-and-pancreases/#sthash.GANsISUe.dpuf(people politics and pancreases)

(people, politics, and pancreases)

Helen Wilde

Helen has been the mother of a Type 1 diabetic since 1979, and has had Type 2 diabetes herself since 2001. She has been a Senior Counsellor with www.diabetescounselling.com.au since 2002.

of us are human beings first. We are sons, daughters, mothers, fathers, bothers, sisters, grandparents, aunts and uncles, friends and lovers. We all laugh, cry, get angry, sad, worry and wonder what life is all about. – See more at: http://www.diabetescounselling.com.au/uncategorized/people-politics-and-pancreases/#sthash.GANsISUe.dpuf

Then, we are people living with diabetes.

– See more at: http://www.diabetescounselling.com.au/uncategorized/people-politics-and-pancreases/#sthash.GANsISUe.dpuf

Then, we are people living with diabetes.

– See more at: http://www.diabetescounselling.com.au/uncategorized/people-politics-and-pancreases/#sthash.GANsISUe.dpuf

Then, we are people living with diabetes.

– See more at: http://www.diabetescounselling.com.au/uncategorized/people-politics-and-pancreases/#sthash.GANsISUe.dpuf

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Eat well and prosper

October 14, 2013 by Sally 2 Comments

Today is my 48^th birthday. That means it’ll be my 36^th diaversary this year! Reflecting on my life with diabetes always amazes me, especially the way that I’ve ended up as a health professional *and* still have excellent health.

I think the *most important* influencing factor over my life has been the constant support and good examples set my wonderful Mum. Being the Mum of a type 1 adolescent is a very difficult thing, especially when the child concerned doesn’t want to know anything about this terrible disease they’ve ended up with. At least, that’s what I was like.

I think my Mum was ahead of her time when I was growing up. She had travelled the world as an air hostess with Qantas and stayed in top hotels across Europe and Asia as a resulting bonus of the job. This gave her an appreciation for delicious food and she worked hard for her four children to teach us about the wonderful varieties of fresh foods that are available to us. I also remember when she turned 40 that she told me she was going to exercise every day of the rest of her life to keep herself fit and in good shape. She used to encourage me to go jogging with her, and we always had active holidays (tennis, swimming, walking, skiing, horseriding, canoeing, bike riding and lots more).

That was just so many years before the 2013 version of the Australian Dietary Guidelines was released that lists as Guideline No. 1 “To achieve and maintain a healthy weight, be physically active and choose amounts of nutritious food and drinks to meet your energy needs.” She really was ahead of her time

Now, all these years later and now being a Mum myself, I can better appreciate just how important that kind of example setting is for the children. My three brothers and I all take an interest in maintaining our own good health, even though we had ‘difficult’ years along the way. That idea of healthy living has always brought us back and for that I am very grateful.

Since I’ve gone on to study and become an Accredited Practising Dietitian, I feel privileged to help those who may not have had such a fortunate upbringing but who are interested in improving their wellbeing to do just that.

I would also like to take this opportunity to applaud those parents/carers of children who have type 1 diabetes, and to encourage them to keep on setting those good examples because it’s a tough job and you need to keep the long-term in sight when the short-term looks difficult.

I encourage you to look to someone you admire who sets examples in their lifestyle for you be guided by. Whether it’s your Mum, another relative, a friend, a mentor of some kind, or even other people who also live with diabetes like the many members and the team at Diabetes Counselling Online.

Of course, it makes sense for us all to do our best to set good examples for others and that can be a great inspiration to help us to stay on track ourselves. I loved the blog by Georgia last Friday – she’s doing a brilliant job already at aged 20, so that can inspire us all!

Thanks for listening, and please join me in trying to make a difference for the lives of others with diabetes, like my lovely Mum has been doing for the last 36 years

Sally Marchini

Sally is the Social Media Dietitian with Diabetes Counselling Online, owner of her private practice (Marchini Nutrition), and has had type 1 diabetes for close to 40 years and coeliac disease for many years too.

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Online Balance

May 6, 2013 by Helen-Edwards Leave a Comment

Sometimes you need a moment away from diabetes. It is so consuming, so in your face, so part of nearly every moment of your day, that sometimes you need to step back and say “enough”. Trying to find this balance can be a challenge. You don’t want to forget about it , or neglect your diabetes, but some days, you just want to push it away a little so you can focus on the rest of your life.

Part of the balance is in finding good support systems. A place, people, a forum, in which you can seek support on the days you need it, but also, feel you can step out of when needed. Too much of a good thing can be a bad thing as they say. Social Media is offering people with diabetes connections like we have never had before. When I got diabetes the only option for me was a camp for kids with type 1 diabetes and I totally rejected it. I was not ready for this mass gathering of all of those people with diabetes. At that stage I did not identify myself with diabetes. I wanted to hide from it. Twenty years later when I had accepted it and wanted more than anything to find people who got it, there was nothing. So I started Diabetes Counselling Online!

And here we are, 12 years later, with a massive online network for people with diabetes and most other conditions, problems, issues and passions you could think of. Everyone is online. So much so, that we know people are starting to lose the ability and desire to communicate in person. Kids are losing their motor skills due to lack of writing and too much swiping screens. People are hooked up to technology 24/7. And I am one of those people who is constantly connected via my smart phone which is kinda not really that smart.

I try to take the weekends to stay as unconnected as I can to the online world and as connected as I can to my family and the world around me. It is tough. There is always the thought to share a photo, upload a thought, write a blog……check what other people are up to. Ultimately I end up not working online so much on the weekends, but still jumping in and out of the online space as I wander through the joy of a weekend with the kids, pottering around, having outings and living life.

Does the online diabetes community offer you greatly needed support? Yet do you sometimes feel obliged to connect? Do you sometimes experience online overload? Or do you feel a good balance between on and offline life? If you can do that then you will find peace with diabetes and with yourself. See you on Facebook

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