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Diabetes

Diabetes2

There are two main types of diabetes, type 1 and type 2.

Type 1 diabetes is often referred to as insulin-dependent diabetes. It is also sometimes known as juvenile diabetes or early-onset diabetes because it often develops before the age of 40, usually during the teenage years.

In type 1 diabetes, the pancreas (a small gland behind the stomach) does not produce any insulin. Insulin is a hormone that regulates blood glucose levels. If the amount of glucose in the blood is too high, it can seriously damage the body's organs.

If you have type 1 diabetes, you will need to take insulin injections for life. You must also make sure that your blood glucose levels stay balanced by eating a healthy diet, taking regular exercise and having regular blood tests.

In type 2 diabetes, the body does not produce enough insulin, or the body's cells do not react to it. This is known as insulin resistance.

Diabetes - Self Assessment

content provided by NHS Choices

What care to expect

Coming into hospital can be an unsettling experience for anyone.

We have a dedicated inpatient diabetes team, which includes nurses, consultants and podiatrists.

We are more than happy to discuss any questions you may have, either before you come into hospital, or during your admission.

We aim to help you manage your diabetes throughout your stay, as well as reduce the risk of any diabetes related problems such as unexpected low (hypos), high blood glucose and foot sores.

At diagnosis

A diagnosis of diabetes can be an overwhelming prospect.

It will involve lifelong change, and we will try and be there for any questions you or your family have.

The majority of patients with type 2 diabetes will be managed in the community with the support of your general practice. You may expect to see a dietitian as part of your overall management.

If you are diagnosed with type 1 diabetes, you will generally be given a hospital appointment where you will see a diabetes specialist nurse and a diabetes doctor. You will also be offered an appointment with a dietitian.

Coming into hospital

We have a dedicated inpatient Diabetes Specialist Nurse team who work closely with the consultant diabetes team and Community Diabetes Specialist Nurses.

We have implemented ThinkGlucose across all our ward areas. This means our staff have had extra training in diabetes. On admission an assessment of your diabetes will be completed to see if you need a referral to the Diabetes Specialist Nursing Team.

If you are worried or have questions about your diabetes management you can also ask to be referred to the Diabetes Specialist Nurse Team. Our wards also have a diabetes link nurse who is responsible for sharing new information about diabetes with their colleagues.

Planned admissions

If your admission is planned you will have the opportunity to discuss your diabetes management at your pre-operative assessment appoint.

If you are having surgery it is important to have well controlled diabetes.

If your blood glucose levels are out of your target range it is helpful to discuss with your nurse or doctor any changes you may need to improve your blood glucose control.

What to bring?

Please bring your diabetes medications, blood glucose meter, if using, and any snacks that you regularly have.

A record of your blood glucose levels is helpful. You may also want to bring your treatment for hypoglycaemia. The hospital also has these in all of our clinical areas.

Unplanned admissions

Most people with diabetes come into hospital for reasons other than their diabetes, and there can be concerns about how you will manage whilst an inpatient.

There are many reasons why your general health can affect your diabetes, from causing unexpected high or low blood glucose. For this reason you may find that we will temporarily change your medicines. This can involve stopping medication, or in some instances introducing insulin as either an injection, or as a continuous infusion. This will be done to try and safely manage your blood glucose, without compromising your overall health. If needed, we will also take the opportunity to review your medication, and suggest long term change.

While we would normally recommend that you have excellent blood glucose control at home, in hospital we aim for a slightly higher blood glucose range, 7-11mmol/l on average. This is because we recognise that low blood glucose (hypos) are more dangerous than high blood glucose in hospital.

Any concerns?

If you have any concerns before, or during your stay, the diabetes team will be more than happy to support you, regardless of your admission reason. We will support your wish to self-manage insulin, and will be more than happy to answer any concerns you may have during your stay.

Mealtimes

Meals in hospital are often different to what you may receive at home.

Often the largest meal of the day is at lunchtime (12-1pm) meaning you may find your blood glucose will be different from when you at home. We will try and anticipate this and hopefully you will not notice any problems with your blood glucose as a result. We offer a snack before bedtime, as we appreciate that you may be concerned about low glucose (hypos) at night.

If you are on insulin, you may notice that mealtime insulin is not given exactly at the same time as you would at home. This can be because there are many other patients on your ward on insulin, and it can be a struggle to give doses simultaneously.

We will support your wishes to administer your own insulin, although there may be some circumstances this will not be possible, for example if you are too ill.

The diabetes team will be more than happy to discuss any concerns.

Insulin and tablets

If you use insulin

If you are well enough and want to you can continue to inject your own insulin and monitor your blood glucose levels whilst in hospital. This is part of our insulin self management scheme. The nurse looking after you will complete an assessment and ask you to sign a consent form to say that you are managing your own diabetes.

If you take tablets

Please bring your tablets with you. These will be prescribed onto a drug chart. The dose of your tablet may need to be adjusted depending on what your blood glucose levels are.

If you are on Metformin this may need to be stopped if you experience diarrhoea or are having an investigation in radiology or cardiology which uses dye.

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