The importance of blood sugar control in the hospital

Medical experts now agree that keeping blood sugars as normal as possible is important to living a healthy life. It also is necessary for the prevention of serious, long-term complications, such as diabetes and the wide range of illnesses it brings. Although it's essential to keep blood sugars low in every day life, it's equally important when you are a patient in a hospital.

Controlling blood sugar is particularly important in patients who have suffered strokes, heart attacks, infections, those undergoing surgery and those in an Intensive Care Unit (ICU). When patients' blood sugars are kept in control it helps:

• Decrease the risk of infections

• Lower blood pressure

• Improve immune system functioning

• Decreased inflammation

• Decreased formation of blood clots after surgery

It is vital for patients to have normal blood sugars prior to any surgical procedure. This is important whether a person actually has a diagnosis of diabetes or whether blood sugars are high due to stress of an illness or surgery. Keeping blood sugars within target ranges reduces complications during surgery, saves lives, cut costs and reduces hospital stays. Here are some tips and things to expect:

Before surgery

• Start controlling sugars several weeks prior to a planned surgery. If diabetic, advise your healthcare provider of your diabetes plan, which should include your insulin doses and meal plan. Also, inform your physician if you have been experiencing frequent episodes of low blood sugar.

• Your healthcare provider may take you off any oral diabetes medication you may be on and put you on insulin prior to surgery to achieve good control. If you previously achieved good control with oral medications, you likely will be able to resume these after healing.

• If on insulin, the dosage may need to be adjusted for long-acting insulin the night before surgery. Your healthcare provider also may discontinue any oral diabetes pills you take.

• Ask who will be managing your blood sugar after surgery. More than likely, the anesthesiologist will be monitoring your blood sugar during surgery.

After surgery

• The first 24 hours after surgery you might have an intravenous insulin infusion to keep blood sugars within a specific target range.

• A diabetes educator and/or a dietitian can be consulted during your recovery period. They can work with you and your healthcare provider in achieving and maintaining desired blood sugar levels.

Flagstaff Medical Center would like to help you prepare for your scheduled surgery. For more information or to contact an outpatient diabetes educator prior to surgery, please call 773-2249.

Elaine Laemmrich, R.N., is a diabetic educator at Flagstaff Medical Center. Is there a health topic you'd like to know more about? Please write to Mountain Medicine, c/o Flagstaff Medical Center, Public Relations, 1200 North Beaver Street, Flagstaff, AZ 86001, or visit FMC's Web site at FlagstaffMedicalCenter.com. For more information, please see your physician.

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