A Successful Hospital Stay
by David M.
I became ill with double pneumonia in March 2022, and was hospitalized in the Washington, D.C. area for five days at one of the leading hospitals. As a person with Type 1 diabetes (T1D) for over fifty years, I was concerned about my care in the hospital. At the time, I was using the Tandem Tx2 insulin pump along with the Dexcom G6 continuous glucose monitor (CGM).
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.)
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