While you are in hospital, your healthcare team needs accurate blood glucose (sugar) readings to make important decisions about your care. This includes decisions about your insulin doses, changes to your diabetes medicines, and how to treat hypoglycemia (low blood glucose level).
Home glucose monitors, including
continuous glucose monitors (CGMs) and capillary (fingertip) blood glucose meters, are not approved for use in Alberta hospitals.
Alberta hospitals must use Health Canada-approved blood glucose meters that are checked every day for accuracy.
While in the hospital, you can still use our home glucose monitor to watch for trends and share the results with your healthcare team.
Your home glucose monitor
There are different types of glucose monitors that you may use to check your glucose (sugar) level at home. These include:
- Capillary blood glucose (CBG) meters are devices that measure the amount of glucose in a capillary (fingertip stick) blood sample at the time it is checked. It is a blood glucose meter that measures the amount of glucose in your blood.
- Continuous Glucose Monitors (CGM) are real-time continuous glucose monitors (rtCGM) and intermittently scanned continuous glucose monitors (isCGM) that measure glucose levels in interstitial fluid every few minutes (continuously).
There are many things that can affect how well the glucose sensor on your home glucose monitor works during your hospital stay. For this reason, your healthcare team won’t be able to use the results from your home glucose monitor to make decisions about your care.
When you’re at home or in the hospital, it’s important to use blood glucose level results (not interstitial glucose level results) to make decisions about your care and treatment when you’re unwell or sick.
Hospital safety guidelines
Alberta Health Services developed the following guidelines with the support of the Diabetes Canada Clinical Practice Guidelines.
Low blood glucose
If you think your blood glucose level is low, call the nurse right away. The nurse will check your blood glucose level with the hospital meter and help you treat it.
If the nurse doesn’t come right away, and you are able, treat the low blood glucose level like you would at home, unless you’re fasting (see below).
When the nurse comes, tell them you had a low blood glucose level, and if you treated it. The nurse will check your blood glucose level with the hospital meter and tell you if you need to do anything else.
Low blood glucose while fasting
If you’re fasting (not drinking or eating anything for a certain amount of time) in the hospital, the treatment for a low blood sugar level may be different than what you do at home.
Talk to the nurse to make a plan in case you have a low blood glucose level while fasting.
Insulin pump with a CGM
You may still be able to use your insulin pump while in the hospital by following the guidelines at
www.ipumpit.ca.
If you use an insulin pump that connects with your CGM, and it is adjusting your insulin continuously, the nurse still needs to check your blood glucose level with the hospital meter to help make decisions about your care and treatment.
CGM and imaging tests
If you’re having an imaging test, you may need to remove your CGM sensor if the sensor is placed in the area that is being examined. This is because the radiation could damage it.
If your sensor is not placed in the area being examined, the radiation is not likely to affect your sensor, and your sensor can stay in place.
In general, you can leave your sensor in place for the following imaging tests:
- ultrasounds
- most x-rays
- most CT exams
- nuclear medicine exams not involving CT
You need to remove your sensor for the following imaging tests:
- magnetic resonance imaging (MRI) (The strong magnet could heat up your sensor or pull it out.)
- radiofrequency (The radio waves could heat up your sensor and cause pain.)
Glucose level targets in hospital
For most people in the hospital, blood glucose level targets are between 5.0 and 10.0 mmol/L, except:
- If you’re pregnant and in labour, the target is 4.0 to 7.0 mmol/L.
- If you’re an older adult with poor health or have dementia, the target is 5.0 to 12.0 mmol/L.
Talk to your healthcare team if you think your target should be different.
