At Rush University Medical Center, we specialize in diabetes management, both inpatient and outpatient. The stress of surgery can cause diabetes to become uncontrolled while in the hospital. Besides the effects of illness or surgery, factors such as steroid use and changes in diet and activity can all affect sugar levels while patients are in the hospital.

To help our patients with diabetes minimize postoperative complications — such as infection and further deterioration during and after pneumonia, stroke or heart attack — we use a team approach to keep blood sugars in the normal range. Research has shown that keeping blood sugar controlled improves outcomes.

The inpatient surgery floors are covered by an endocrinologist, endocrinology fellow or endocrinology nurse practitioner 24 hours a day for patients with diabetes. The nurses know to page the practitioner from the endocrine team when they receive a patient with elevated blood sugar. Each patient is followed closely until discharge. The blood sugar management plan is individualized according to the patient's specific needs and other medical conditions. Patients are taken off any oral diabetes pills and placed on an insulin regimen. Patients who receive insulin in the hospital do not always need to take insulin at discharge; most return to their diabetes pills at discharge.

Patients are provided with diabetes education on an as-needed basis prior to discharge and given our outpatient endocrine clinic number for questions or follow-up if they choose. Some patients who do not have diabetes will find that after surgery they may temporarily require insulin due to high blood sugar from stress, but sugars typically have normalized by the time of discharge.

• David Baldwin, MD
• Tiffany Hor, MD
• Chung-Kay Koh, MD
• Sirimon Reutrakul, MD
• Christina Munoz, NP
• Sandy Donaldson, RN, CDE