The hospital endocrinologist and nurses spoke with me so that they could be assured that I was very knowledgeable about T1D and my care with the devices I had. I told them my HbA1C levels regularly ran about 6.0. This reassured them that the pump basal settings and I would keep my glucose levels within or close to the pump’s target range of 75 to 180.

They did not speak to my endocrinologist because they were comfortable that I could manage my diabetes with the approval of the nursing staff. In contrast to the experience of many with T1D who are hospitalized, I was given permission to manage my own T1D care with the oversight of hospital personnel. I was asked to sign a release form that I was assuming legal responsibility for my T1D care.

At the time, we did not discuss what we would do if I needed to treat a low or high blood sugar reading, though I had glucose tablets by my bedside table. If I had had a low glucose reading, I would have taken four glucose tablets of 16 grams of carbohydrates and told a nurse or nurse’s aide. If I had a high glucose level as shown on my pump from a
reading from my CGM, I would have used the insulin pump to calculate a correction bolus and spoken to the nursing staff before I delivered the correction. To my recollection, I did not need to correct during my stay.

Before meals, I was able to deliver boluses with the approval of the nursing staff. I calculated my boluses with my pump once I set the carbohydrate amount. I was required to receive permission for each bolus I programmed into my insulin pump based on the amount of carbohydrates I was going to eat. Luckily, the hospital menu had calculated the number of carbohydrates for each meal selection. Because I could not know when a meal would be delivered – I ordered three meals a day – I waited to bolus until the meal came to my room.

They performed periodic finger pricks to check my blood sugar levels. I was frequently checking my own blood sugar from my CGM on my pump. I was not using the G6 receiver. I was able to change my infusion sites and load my pump with Humalog insulin using supplies my wife brought to me from home.

(Note: For a T1D on a pump, the treatment “plan” is built into the pump settings. My state has no law that lets a T1D control her or his care in a hospital.)