Diabetes is a serious condition, but fortunately it typically doesn’t require hospitalization except in severe circumstances. Even so, patients with diabetes who are admitted to the hospital for other medical issues face a greater risk of complications—especially infections—and hospital readmission. 

"Bugs like to live in high sugar, so patients with diabetes who have a surgical wound that is open and healing can get infected much more easily," said Roma Gianchandani, MD, medical director of Diabetes Quality at Cedars-Sinai. "Also, many people with diabetes have other conditions, like high blood pressure and kidney issues, that can get worse during hospitalization."

Even people without diabetes could be at increased risk of high blood glucose during a hospital stay. This condition, called stress-induced hyperglycemia, is when patients without preexisting diabetes have high glucose levels due to stress from illness and medications.

This makes it all the more important that people with diabetes, or those who are prone to stress-induced hyperglycemia, advocate for themselves during hospitalization, Gianchandani said. Here are her tips for navigating these conditions during a hospital stay. 

Several diabetes medications and GLP-1 agonists such as semaglutide (Ozempic) are not used in the hospital. If you need an oral medication, the hospital will provide the appropriate one.

If you wear a continuous glucose monitor or an insulin pump and it’s possible to contact your doctor before your hospitalization, ask whether you can bring it to the hospital. Cedars-Sinai allows most hospitalized patients to wear these devices.

In the hospital, continuous glucose monitor readings are corroborated with blood sugar tests, so expect finger-poke testing during your hospital stay. This is because continuous glucose monitors are not yet approved by the U.S. Food and Drug Administration for the hospital setting.

If you’re bringing your wearable diabetes device to the hospital, remember to pack extra supplies, including batteries and adhesives.

Read: Continuous Glucose Monitors: Why Wear One?

Tell your hospital care team about your diabetes diagnosis, especially if you have Type 1 diabetes, so you can always have long-acting insulin. 

"If I come in with a heart attack, is someone also watching my blood sugar?" Gianchandani said. "Sometimes a patient will come in with a severe disease, and their diabetes is less of a focus. You want to make sure it’s considered so that all metabolic processes are addressed to help the person heal well."

With so many patient priorities in the hospital, sometimes diabetes management can get off track and cause blood sugar problems. One example is ensuring a patient receives their insulin with their meal when they have been rushed to a test. 

You also can ask your care team about your blood sugar test results and any changes made to your diabetes medication while you’re in the hospital. 

If you’re told at the hospital that you have stress-induced hyperglycemia, you can ask for an A1C test to differentiate this from a new diabetes diagnosis.

Some people who experience stress-induced hyperglycemia in the hospital recover before they go home. Others may not recover until after they leave the hospital. You can request to meet with an in-hospital diabetes educator, who can teach you how to manage the condition at home. This includes ensuring you know how to check your blood glucose and use at-home treatments, such as oral medications or insulin.

If you have time during your hospitalization, you can take advantage of available diabetes education. For instance, a team of Cedars-Sinai diabetes providers prepared this video series to introduce hospitalized patients to diabetes care. 

Diabetes educators often visit hospitalized patients with poorly controlled diabetes, people with a new diabetes diagnosis, patients who have had transplants and pregnant patients with diabetes. However, Gianchandani noted that comprehensive diabetes education is best provided in an outpatient setting with highly qualified diabetes educators, such as the Diabetes Outpatient Treatment and Education Center at Cedars-Sinai. 

When it’s time to leave the hospital, make sure you’re clear about next steps. If you were newly diagnosed with diabetes or stress-induced hyperglycemia, or if your diabetes management changed in the hospital, plan to follow up with your healthcare provider in a few weeks. 

"Transition of care for diabetes is important, because often the drug that is used in the hospital may not be the one that is either covered by insurance or the one the patient is going home with," Gianchandani said. "Have a plan for when you’re home."