I recently fell and broke my ankle which required a short stay in the hospital and several days of inpatient rehab.
I take a fairly large dose in insulin daily:
100 units Tresiba (Slowly lowering it thanks to Monjero - but still high)
20-25 units Novolog four times/day BEFORE meals and as need
Your endo shouldn't require an appointment to revert back to your original insulin prescription. It's normal unfortunately for hospitals to not give enough insulin and to not give mealtime insulin when it's supposed to happen. But sending in a prescription for insulin when you already have an active insulin prescription is not normal or okay.
I've sent her a note, but of course it's Saturday, so I don't expect an answer for a couple of days.
Does your Endo have CDEs in the office? It might be faster to get an appointment with a Certified Nurse Educator.
This is something that your Endo should be able to resend your existing prescriptions based on it not being covered and the hospital Dr not being your normal Dr, what gets me is them CANCELLING your existing prescriptions that your insurance covers... Did the hospital make you surrender your insulin and not give it back when you were discharged? They've tried that with me before.
Fortunatly they did not take my old pens since they would not even let me bring them, and I had just filled a 90 day supply a couple of weeks ago to get ahead of the new year.
It just pisses me off that they would do this... especially the cancelling my existing prescriptions.
Great news, I went in one time (between when I could get Dexcom) and I was going for something else and since I'm diabetic, of course they are going to demand to treat and manage all medications, well, I'm REALLY brittle and around 100, sometimes 110, I'll be that way for hours and then I may do a little drop of 5 in 10 minutes or not, but then in another 10 I'll be around 65, then lower just outta nowhere... They did the glucose check, 85, I think uh oh, hey, can you hand me my pouch right there? Opened it, started to grab a gel, they're like you can't have that, you're not low enough to treat, were can't let you have anything unless it's 55, that's our standards I'm like I'm about to vote right past that and there's gonna be trouble from it, doctor tries to give me the "I'm a doctor and
This sounds horrible and it’s my nightmare! Please tell me you sued them!
No, but it was made supper clear to hospital management before I left that I was upfront about my condition, if they'd actually looked at the chart it would have been apparent I was under the care of an Endo that was part of their staff, with privileges at that hospital and they were being contacted, and I filed a complaint against the hospital about it and demanded that they review their policies on treatment of insulin dependent diabetics
My Endo? She... Was... Pissed...
Makes you wonder why they have notes in the first place when people rarely read them.
I know right?
THIS. I lost my insurance for a moment in time with no job so I went to a low income wellness center. I tell them im a type 1 diabetic on the intake form. I tell the nurses who check me in. I filled out the patient history emphasizing type 1. I even added notes about my pump.
Doctor walks in i introduce myself and tell them a type 1 diabetic And you know what the doctor immediately does without even a cursory glance at the notes is start pushing glp-1's until I bring out my pump to show her. And then she tries to gaslight me like it was my fault I didn't tell her and she inexplicably just gave me bad medical advice.
I see her add to the notes so I move on no big deal. Second visit at the same clinic same nurses but different doctor. I introduce myself and she immediately starts pushing
Call your pharmacy and complain. Prescriptions can’t really be cancelled just the pending refill. That pharmacy should have them still.
I did, they told me that once a replacement prescription comes in it automatically cancels any previous prescription for the same or very similar medication. The only way to overide it is to get a Doctor to write yet another prescription to overide it.
So, it cancelled by Tresiba and replaced it with Lantis, cancelled my Novolog and replaced it with Humalog.
Just three weeks ago I made sure that my Part-D plan covers the insulins I take, and they switched me to two that my current plan formulary doesn't cover.
Next time, just tell them a completely different pharmacy that you want the prescription sent to.
Nice thought, but worth how connected everything is? Likely won't work and could get you flagged in their system as being non compliant or similar I can't do any pain treatments in my main medical stuff because I have an external pain specialist., And was trying to get all my doctors under the same roof so they can more easily communicate, but the pain Dr demanded that I surrender all meds, he was just oh, no, you shouldn't be on anything sooner than an over the counter Motrin, I have several blown disks, needs replacements for a hip and both knees and have lots of back problems because of a high fall... Yeah, no, not happening, I don't need that
If I ever have to step foot in a hospital I'm bringing my messenger bag with my laptop, a charging brick andf ALL OF MY DIABETIC SUPPLIES. If they ever try to eff around like that I will take control of my own care. I've never had to do it, but after hearing stories like this starting a few years ago, I decided I would never let it happen to me if I had any say so in the matter.
Good plan. Last time I was in hospital with anything diabetes related a doctor tried to kill me with insulin. I only lived because I had plenty of my own supplies (incl. sugar).
They will confiscate your medications and destroy the ones they can't confirm. Do not take your own prescribed medication. Either way, they will administer it for you and will not allow self management. It's incredibly frustrating but not worth losing your supplies.
They don't need to know I have them. And they can rip them from my screaming body.
I work in a hospital (not medical but work the floor) and none of this surprises me. If anyone with DM gets admitted, even if their admitting dx is nothing to do with their DM, our Diabetes Management team manages their DM care/medication. The attending can't even discharge them until Diabetes Management does their med rec, sends prescriptions etc. We don't carry all brands of insulin so we do sometimes have to switch people, and the hospital has policies about home meds. Diabetes Management inevitably messes with people's meds and discharges them on the most complicated combo possible.
I'd encourage you to reach out to the hosotal's patient lisaison/advocate or patient experience to explain what happened. Hopefully your endo won't require you to get a new appointment to resend your presc
We've had to take our type1 kid to the hospital more than once, they never said a thing about managing diabetes. "We trust you to take care of your kid." And "Oh kid is on a CGM? Then we don't see the need for regular pokes, just let us check the reading as needed." They've definitely never tried to override our prescriptions.
I'm glad that hasn't happened to you. That's how all if hospitals in my area operate. I personally think it's a terrible idea unless someone is coming in with DKA or DM complications. It also throws off the flow on the unit which has screwed up discharges.
Omg that’s ridiculous to change your prescriptions. Do you have a hospital web portal for your doctor? Send him a message directly and explain the hospital for some reason changed your prescriptions and you need them readjusted. It does not require an appointment. You want to use the portal because it leaves a paper trail, they will address it much faster. If that fails, any doctor whether it be a primary or an urgent care or one of those CVS minute clinics can write a new prescription for you.
Hospitals are terribly bad at diabetes care. They usually run you higher as at least you’ll live while they address the main issue you’re there, as per their protocol. However they shouldn’t be messing with your current dosages prescribed by your doctor! I would contact the hospital administrator
How could they cancel your prescriptions written by your doctor?
Your latest script overrides your current script (for similar/same types of meds) at a pharmacy, doesn't matter who the doctor is. Standard procedure.
Your GP can write you scripts. Your endo can write you scripts, your dentist can write you scripts. A clinic can write you scripts. etc.
The pharmacies job is more to check that your scripts are not for the same purpose. ie: make sure you are not double dosing on something.
Not for a different insulin. I have a prescription for Novolog and Lyumjev cause sometimes I need a faster insulin. Maybe the hospital did it.
The pharmacies job is more to check that your scripts are not for the same purpose
Sure, and the pharmacist is free to contact the doctors if they think that there is a problem.
They don't need the power to unilaterally cancel prescriptions without telling anyone to do that.
My doctor sends my regular prescriptions with about 5 clicks of a mouse. Should be something you can ask for in the portal.
I haven’t had that happen before but you should be able to tell the pharmacy to ignore those scripts.
I would send a nicely worded, but very pointed, letter to the hospital's legal staff. This would also, in my opinion, require a complaint to the state medical board.
Sorry to hear this happened. Hopefully your ankle will heal well.
I dealt with a VERY INEPT dietician & diabetic specialist while in the hospital during a 3 month stay from cardiac arrest after my kidney transplant in 2023. After the first few weeks of the hospital trying to use Reg/NPH to get my BG under control, I forced them to allow me to revert back to my regimen of Novolog/Lantus (A1c usually 5.8-6.0). After they relented, my BG was back to normal and they gave me free reign to adjust my doses (with their approval of each dose). This gave me a huge advantage, that the nursing staff knew WTF I was doing and listened to me before doing anything.
All I can say is having a very close relationship with all the doctors you normally see, will have your back if you need that support outside the hospital nightmares.
Your Endo should be notified immediat
I've had a similar thing happen with a hospital dietician!
Not only did they serve me insanely carb-heavy means, with lots of sugary items (pudding, full sugar Jello), they served me food I'm ALLERGIC to which are listed on my medical records that were reviewed by the department.
It took me several meals before I managed to find the Patient Advocate at the hospital and all but demand they come up to my room to see what was going on.
Wow! Sounds like a garbage hospital. I'm always on top of EVERYTHING anytime I go into any procedure to (hopefully) prevent these sort of things. I've had nurses apply large Tegaderm patches over an IV AFTER I reminded them multiple times NOT to use any heavily sticky covering (I am on multiple meds that give me very thin skin), Of course after 3 reminders she still slapped it on there, probably so stuck in her normal routine, that she really wasn't paying any attention to what I was discussing with her. Another nurse in post-op started to remove it again after I reminded her to use that oily adhesive solution. Tore lots of skin on the inside of my elbow. Actually got to file these issues with the coordinator. Heard both those nurses were "reprimanded" but who knows if it helped.
Fwiw, it turned out that the dietician didn't do special diets - she just had various meals planned out, including kosher, for roughly two weeks of food. Which she then recycled so twice a month folks had repeat meals.
I hadn't thought that far ahead to consider the dietician was lazy, I'd met with anesthesiology, the surgeon, and even the post-op nurse who verified my food allergies and diabetes that morning. By all accounts, things should have gone smoothly were it not for a dietician who was phoning it in.
Sorry you had to deal with that ineptitude. I guess I got lucky that they were very hands-on to adjust things for me. I was very adamant at the beginning and it worked once I took control.
Last year I was in the hospital with sepsis. I had to sign a waiver so they would allow me to monitor my diabetes and use my insulin pump. I actually argued with the nurse in charge of the station I was at about it. I ended up having my husband bring my supplies from home so I could take care of my diabetes while the hospital flooded my veins with antibiotics.
I’ve learned that you have to nag the care team about diabetes. None of them have any idea how to manage it.
Sorry you had to go through that. Hospitals are notoriously bad for people on insulin therapy. I am convinced if I die early it will be due to hospital negligence.
I’ll fire any doctor that tries to adjust my pump/cgm if I’m there for something unrelated. Any nurse too.
Nurses have to do what the doctors tell them to do or they get in trouble. I would never blame a nurse for following the doctors orders.
To be honest, I was quite pleased with pretty much everything that happened while was there, except for this one item at checkout!
Doesn’t mean I want them in there if they’re going to follow those orders. Find me someone else that’ll call my endo.
They tried to tell me the same and I told them I was handling my insulin but id chart it for them.
Unfortunately hospitals are very conservative with insulin (they don't want to deal with lows), but your old RXs should still be active. A hospital shouldn't be able to completely remove an RX.
Your pharmacy should be able to reactivate your old RX.
Hospitals will do just about anything to avoid "low" blood sugar since it's more dangerous short term than high blood sugar. My local hospital loves to make me spike to avoid a low and then hold me for observation for an additional night/24 hours because my blood sugars are high. It's beyond infuriating. Just have to advocate for yourself. You are allowed to refuse medication/treatment. Obviously you don't want to throw that in their faces constantly or for no reason when they're just trying to take care of you, but if you know something will adversely affect your health you can stand up for yourself. Tell the nurse or doctor that you know what a change in medication will do and you refuse that course of action as you know it to be damaging to your health and ask to speak to someone who ha
Endo should be able to resubmit the old scripts. Or your primary care.
Electronic medical records suck. When a patient is discharging from the hospital, it will often make it seem like you have to continue the medications that they’re on. So either someone who is inexperienced, or isn’t thinking about it, will sign prescriptions for what they’ve been doing in the hospital, even though you don’t need them.
Very irritating.
Any type 1 who is admitted to the hospital should explicitly tell the hospitalist to not fuck with their outpatient regimen.
I once had something very similar happen, but it was decades ago and I don't remember all the details. Basically just that I was hospitalized for some other reason, they wanted to manage my diabetes while I was in there and they had no idea how to do it.
Go to urgent care and beg. I’ve done that.
Also the endo shouldn’t make you wait 3 months for a med “refill”/change.
the hospital is more concerned with having you not drop low then keeping you in range - stupid, I know, but that is how it is.
Your blood sugars are likely to remain high even after you get switched back to your regular regime for a while. You are not going to be as active as you would like to be and you are injured - basically your body is under stress.
Last time I was in the hospital was for DKA, they tried to completely take me off insulin for multiple hours while I was in recovery. For DKA. The thing you get when you don’t have enough insulin? The thing you’re supposed to take double the dose of insulin for? Anyway I don’t go to the hospital anymore unless I’m going to die without it.
Stupid question here but can’t you do your own insulin in the hospital?
No! At least not if they know about it.
That’s crazy. This came up on my feed but I only have gestational diabetes, but anytime I’m admitted I’m left to do it myself
Similar experience here, both times delivering children. Such a pain in the ass. At least for the second time, I convinced them to let me manage my own insulin after signing a form waiver and endorsement from my high risk OB.
I am only 1.5 years into diabetes and 6 months into a T1 diagnosis but here is what I was told by my pump education nurse:
“I don’t care if you go the hospital for a single stitch in your thumb, if you are conscious and able to speak, you immediately ask for an endocrinologist consult and that you will not discuss anything diabetes related until you see an endocrinologist. If you are unable to speak you tell your emergency contacts to immediately ask for an endocrinologist consult. In the hospital, this is THE time to advocate for yourself and your care. if you have good management of your diabetes, talk to an endo in hospital, and advocate for yourself you will 9 out of 10 times get permission to manage your diabetes yourself.”
She’s a badass lady and despite not being diabetic herself
It's like they got to the part about oh, he's an insulin dependent diabetic, I know how to treat them, only test by blood 2 times a day and only give insulin if they're over 200 and only give bolus for that midday meal they'll be testing for
Yeah, that was the plan I think, because that's happened before.
Now they pretty much leave me alone because I have a pump, and after that and a time of being in the hospital between working and getting social security and having to try to ration the hell out of my last bit of insulin, I wind up popping a fasting 500, on my birthday, so it was too the hospital, 4 DAYS of NO FOOD!, and 2 glucose checks a day, morning, and two it's after they would have served lunch, but four days of only water and an IV in my arm for my anniversary too...
But, I go
How much do you weigh to be taking so much insulin daily ?