How do other people with diabetes survive hospital stays?

I'm not sure what hospitals your friends are going to, but I have type 2 diabetes and never had an issue with food being served to me. Also, you made the point to say "American" this and American that. What country are you and your friends from originally?

Yes, I had that experience both in the hospital and in the nursing home. Despite my many conversations in the nursing home describing my needs, the young girl who made up the trays, had to follow her orders so I got food I did not eat. My family bought me food from the garden and a restaurant that was safe for me. In the hospital we can order anything we want anytime, but they deny food according to their protocols instead of our program we have worked out. When medicines cause the blood sugar to spike, they don't worry about what you eat and fall back on insulin to "keep you safe." Most doctors do not believe you are willing and capable of following a strict diet, so they use insulin to make their responsibility easier. They don't have time to count your carbs before they bring you food. Their protocols are not always up to date . It is an easier standard that suits them in their busy day. They realize that their protocol may be temporary and you will be home in a few days and can do what you need to do. They sent vials of insulin home with my husband who never followed a diabetic diet and would not accept insulin shots and they told me to give him the shots. I said I couldn't make that happen. I threw them out.
I said I was not able to care for him adequately at home. They did not reply to that. They pretended they were sending him home with adequate care.
He was in the hospital four times the year he died, and bragged that he ordered and ate what he wanted, as if we were all wrong in our desire to prepare the right food for his condition. His attitude aided in his early death. I was blamed for not feeding his correctly. He didn't eat much at home, but was addicted to restaurants. It was a nightmare. At least I am not responsible in any way for his death. The hospital avoided confronting him with his eating. Everyone was happy, right? You can't force education and compliance on a patient in denial, and they know that. Dorisena

I lost 16 pounds immediately after back surgery and it took some days before the nutritionist came to find out why I had lost that much. They weighed me and were worried but they had me on a healthy heart diet with onely one half banana, no butter which I eat regularly, and too much white crackers and bread.
It was no time to be worrying about the fat in a diet with all that weight loss. They had no prunes but did bring me prune juice which is essential for my constipation, which comes from too much drugs, etc. It is a merry-go-round problem. But I avoided insulin this time. Dorisena

I’ve had the same experience several times. My guess is that it depends on the reason you were admitted. That is, if your endocrinologist is the doctor listed, your diet would include a diabetes friendly diet. If any other doctor is your admitting doctor (for a heart condition, bone issue, etc.), its up to you to request a diabetes-friendly diet.

Unfortunately, many times we are viewed as sheep and not smart enough to know our own medical needs. Once my situation was explained, I’ve been allowed to look at what is offered for the upcoming meals and select my own foods. The bottom line is that we are responsible for our own health care, and if we don’t speak up, it’s our own fault.

In my experience, to prevent this from happening, make certain you mention it (you are a diabetic and require a special diet) to the doctor admitting you before you are actually admitted into the hospital.

You are right, Howard that we should speak up to get our diets that we need. But in some places the right hand doesn't work well with the left hand, and it still doesn't happen well. If you refuse the food, they mark you down as not eating well and come to speak with you. The other side of the issue is that I couldn't use the Metamucil I brought with me to the nursing home for my constipation instead of laxatives. They took it away and said it wasn't a laxative. They didn't have prunes available. The laxative they provided didn't work on me. I had pain and the meds they gave me didn't help. So I spiraled down into a cranky patient until I could get out of the place. It would be difficult to get me back into a nursing home despite the high quality of care, because of the food issue.
One nursing home had two standards of food service, one for public eating and a different one for rehab patients. Their public reputation was excellent and their patients were not believed when they complained. But I don't speak about it to my friends. I don't like being a troublemaker in public opinion. Dorisena

In the "big" metro hospital where I have been, you can order food anytime and have it delivered in good time and they really try to accommodate you except for their "healthy heart" policy. They allowed my husband to have his soft, high carb diet and then gave him insulin to cover any high numbers. That made it easier for them. They wouldn't listen to me because my husband wouldn't sign the paper giving me access to his treatment. He won, I lost. I cooked two different meals at home until he died. Dorisena