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  Chat Transcript
Open Forum with Karen Baker, C.D.E.   April 18, 2012

KarenB@Unity:
Welcome to the Unity Diabetes Online Community! I’m Karen Baker and I’ll be hosting today’s chat. We’re glad you could join us today, we’ll be answering all of your diabetes questions and spending some time sharing insights on what type of care patients with diabetes need while in the Hospital.
KarenB@Unity:
Before we get started let me just tell you how we’ll address your questions and comments today. I answer questions one at a time, in the order that they are posted to the site, and there might be a slight delay as I respond to each question. It may take a few minutes for me to type answers to your questions, so please stay logged-in to the chat to see my response, even if it takes a few minutes. And you might need to refresh every few minutes to keep up with the latest posts in the chat if you switch to another application on your computer. Let’s get started.
lucyblue:
Hi Karen,
I have a question about the last time I was in the hospital, it was a couple of years ago but I remember getting so much food - and it seemed like way more carbs than I usually eat - but since the hospital gave it to me, I thought it was ok to eat so I didn't carb count...is that ok?
KarenB@Unity:
Hi lucyblue. Great question. The hospital provides a "Consistent Carbohydrate Diet" for all patient's with diabetes. The amount of carbohydrates you receive will be consistent at breakfast, lunch, and dinner. Consistency seems to work the best for overall blood glucose control. The amount of total carbs you receive are somewhat standardized and may not be representative of what you have found to work the best for you at home. You know your own needs best.
sassy35:
 Who can I talk to when I'm in the Hospital about what they serve? I had similar concerns last time I was there, but didn't know who to ask.
lucyblue: 
 Do all hospitals have Consistent Carbohydrate Diet for people with diabetes?
KarenB@Unity:
My general recommendation would be to have a discussion with the hospital doctor and/or dietitian and discuss what you are doing at home vs. what they are providing you in the hospital. Tell the staff what has worked well for you in the past.
KarenB@Unity:
Hi sassy 35. Thanks for joining in! You can always ask to speak with a registered dietitian. 
KarenB@Unity: 
Lucyblue - Unity Hopsital provides a Consistent Carbohydrate Diet, which is the trend nationwide.
lucyblue:
I heard at Strong you can order whatever you want to eat off of the menu, is that a consistent carbohydrate plan?
sassy35:
When I was in the Hospital they would not let me check my own blood sugar. Why couldn't I do it myself?
KarenB@Unity:
Lucyblue - I am at a little bit of a disadvantage here because I am not affiliated with Strong Hospital, but it is my understanding that they have implemented a "restaurant style" menu with a consistent carbohydrate meal pattern built into it. So, you can theoretically call to order anything you would like on the menu, but you will be speaking with a trained employee who will guide you through your selections and let you know when you have ordered something in excess of your carbohydrate limit.
lucyblue:
OK thanks - good to know
KarenB@Unity:
Hi sassy 35. Hospitals provide insulin and diabetes medications to you based on your blood glucose values. They use glucose meters that have been calibrated and meet stringent standards to provide the most accurate result. These results are entered into a system for all appropriate staff to see and review. Your home meter's results cannot be shared electronically with all staff and has not met these calibration standards. I hope this helps.
sassy35: 
That makes sense - thanks.
lucyblue:
When my mom was in the hospital they took her off her oral meds and put her on insulin - why is that?
sassy35:
I got a cold last week and I think my blood sugars were higher that usual - is that normal?
KarenB@Unity:
Hi lucyblue. It is pretty common for oral medications to be temporarily suspended in favor of insulin for those admitted to the hospital. Insulin seems to best target blood glucose levels that can be elevated as a result of stress or illness in hospitalized patients. Also, oral medications are often associated with side effects, while there are very few risk of side effects with insulin. Often patients can return to oral agents after discharge.
lucyblue:
Yes, my mother went back to her oral meds, she doesn't use insulin at home.
KarenB@Unity:
Sassy35 - Yes, illness and stress are factors that commonly contribute to elevated blood glucose levels. For these situations, increasing your fluid intake of calorie free beverages can help bring down blood glucose levels. If blood sugars remain high, I always recommend a call to your doctor for advice.
KarenB@Unity:
Glad to hear, lucyblue.
KarenB@Unity:
That’s all the time we have for today. I’ve really enjoyed our conversation and hope that I was able to provide some insight for you. If we didn’t get to your question today or if you think of another question later on – feel free to jump into the conversation in the forum, or submit a question using our “Ask an expert” feature. Be sure to join us for our next chat Wednesday, May 2 at 12 p.m. with Joy Valvano and Dawn Jeffords from the American Diabetes Association.
 
 
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