From Durham, England:
My 15 year old daughter has only very recently been diagnosed as having diabetes. She was admitted to hospital and although I feel she has received a lot of care she was in and out of hospital within 3 days. There is support also at home but I wondered why everything they did in hospital was done so quickly.
I'm sorry to hear that your daughter has been diagnosed as having diabetes. This is always a traumatic experience no matter what the level of care. Most hospital diabetes teams now work on the principle that they don't wish to keep patients in hospital for any longer than is necessary for them to recover from the initial "illness." What this means will vary from place to place dependent upon resources and also the degree of decompensation in the patient at the time of diagnosis - a patient who has simply been thirsty and passing too much urine can be treated differently from one who has been vomiting and has required a drip and intravenous insulin.
The first steps in the education process may have to be carried out in hospital but many centres now have enough community support that they don't require patients and their families to "swallow a dictionary of diabetes" before discharge.
The whole thing comes down to safety. Insulin is a potentially lethal medicine and it would clearly be unwise to send someone home with it unless there was confidence about their ability to administer it safely and the ability of the healthcare team to offer adequate and timely support. There is ample evidence that parents and families who have had very short admissions (or none) do as well as those for whom admission has been required. In fact, in Leicester, the non-admission group went on to have fewer diabetes related admissions. Blood sugar control in the two groups was identical.
My own experience suggests that families much prefer to come to terms with diabetes in the familiar environment of their own home (of course with adequate support) than to be incarcerated in hospital where the patient is highly likely to pick up an infectious disease such as gastroenteritis.
Original posting 12 Dec 97
Last Updated: Tuesday April 06, 2010 15:08:56
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