A hospital is a health care institution providing patient treatment with specialized medical and nursing staff and medical equipment. The primary mission of a hospital is to provide medical care to patients. This care includes the diagnosis and treatment of illness, injury, and other physical and mental impairments. Hospitals also provide preventive care, public health services, and education. In order to provide these services, hospitals require a constant supply of food. This food must meet the nutritional needs of the patients, as well as the staff. A variety of factors must be considered when planning meals for hospital patients. These include the patient’s age, sex, culture, religion, and medical condition. The hospital’s budget, as well as the availability of food, also play a role in meal planning. Meal plans for hospital patients are designed to provide the necessary nutrients for healing and recovery. They are also intended to prevent or manage conditions such as diabetes, heart disease, and obesity. A typical hospital diet includes plenty of fruits, vegetables, whole grains, and low-fat proteins. Patients may also be given supplements to ensure that they receive the nutrients they need.
Medical nutrition therapy (MNT) is a critical component of diabetes care. MNT should address these issues in addition to illnesses and medication changes. Patients’ nutrition care plans must be tailored to their medical treatment plan in order for a team approach to work. Identifying yourself as a patient with diabetes is the first step in providing nutrition care to them. Because there aren’t as many clinical dietetics professionals in hospitals, it’s difficult for patients with mild to moderate nutrition risk to get the necessary interventions. Individuals with diabetes should be considered to have a high nutritional risk. In the hospital, it is often difficult to follow a normal food plan and, in some cases, it is impossible to eat at all.
There are numerous barriers that can make it difficult for people to maintain an adequate level of nutrition, including catabolic stress, changes in medications, and a need for enteral or parenteral nutrition. Diet modification can be one method of nutrition intervention, along with specialized nutrition therapies and counseling. Hospital administrators are beginning to accept the use of carbohydrate meal plans in their kitchens. Patients with diabetes on this plan will not be required to consume a specific number of calories, nor will there be a specific fat content. Meal plans that discourage concentrated sweets, add sugar, or limit sugar consumption are no longer safe to use. Snacks should not be required as a means of meeting patient needs or as an option to supplement diet. Once a patient has tolerated the transition from clear liquids to solid foods, it is critical that they begin to transition from full liquids to solid foods as soon as possible.
When possible, nutritional supplements should be taken orally through the enteral system. Diabetes education should be identified as an annual priority for clinical hospital staff by surveying them or using performance measures. When all staff members are familiar with the rationale for treatments, protocols, and policies, they are more likely to support and implement them. Table 4 lists a few common nutrition-related issues that make it difficult to achieve optimal glycemic control while in the hospital. This article was written by members of the American Dietetic Association’s Diabetes Care and Education Practice Group. A survey of hospital nutrition care was created from an electronic mailing list. The study, which was published in Diabetes Care 25, was published in 2004.
The best way to control hyperglycemia is to give insulin in the inpatient setting, particularly in critically ill patients. As an alternative to insulin injections in the intensive care unit, insulin is delivered via intravenously.
