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Hospitals must follow standards for monitoring of blood sugar using blood glucose meters. These standards are in place to ensure your safety.

The Ottawa Hospital uses meters that automatically upload blood sugar results into the patient’s electronic (computerized) chart. These meters undergo quality control to verify their accuracy on a daily basis. The standards also require that all insulin doses and medication adjustment decisions be made using the hospital meter. For these reasons we must use the hospital meter while you are admitted to hospital. You may use your meter if you feel unwell but doctors, nurses or even you can’t use the results of your own meter to make changes to medication and insulin doses.

If you feel unwell or think you are having a low blood sugar, call for the nurse right away so that he or she may confirm your blood sugar with the hospital meter and help you as needed. If your blood sugar is low with your meter and the nurse is not responding quickly enough, you can treat it the way you usually do at home as long as you are not fasting. When the nurse comes she will test your blood sugar again with the hospital meter.

If you use a meter that communicates with your insulin pump this does not mean that you can’t use your pump while in hospital. You can still use your pump’s bolus calculator or bolus wizard but you will have to enter the hospital meter blood sugar manually into your pump. If you do not know how to do this, ask to see one of the Diabetes Nurse Specialists and they can show you how to do this.

Continuous glucose monitoring  (CGM)

The use of CGM is not approved for use in patients admitted to the hospital. Medications such as acetaminophen (Tylenol) can make CGM less accurate (falsely high readings). You cannot use any of your CGM readings to decide what insulin dose to take. If you would like to continue to use your CGM so that you can benefit from the alarms or to look at trends you can continue to wear it but we cannot use any of your CGM readings to adjust your medication or insulin doses. You should not decide what insulin dose to take based on the CGM readings while in admitted to hospital. Your blood sugar must be checked with the hospital blood glucose meter before treating a high or low blood sugar.

Note: You must remove your sensor for any tests with x-ray, MRI or CT scan.

Flash glucose meter (Freestyle Libre)

This type of meter is not approved to be used in people admitted to hospital. Vitamin C (ascorbic acid), aspirin and medications containing salicylic acid can make the readings less accurate (falsely high or falsely low).You cannot use any of your Libre readings to decide what insulin dose to take. If you would like to continue wearing your sensor to look at trends you can continue to wear it but doctors, nurses or even you cannot use any of these readings to adjust your medication or insulin doses while in hospital. Your blood sugar must be checked with the hospital blood glucose meter before treating a high or low blood sugar.

Note: You must remove your sensor for any tests with x-ray, MRI or CT scan.

Blood sugar targets while in hospital

Because being in the hospital can disturb your usual routine and meals there is a higher risk of low blood sugars. For this reason Diabetes Canada guidelines recommend that when people with diabetes are admitted to hospital, the blood sugar target should be between 5 and 10 mmol/L (in non-pregnant persons). If you are pregnant, the recommended blood sugar target is 4 to 7 mmol/L.

Having blood sugars in this range for a short period does not cause any harm or long term complications. However, having blood sugars that are higher than 10 mmol/L can slow down healing and put you at risk of infection. After you are discharged you can go back to your usual recommended target range unless the doctor or nurse advises you differently at discharge.

Last updated on: November 1st, 2017