Using CGM in hospital (1877)

Can my child’s insulin pump or CGM be used in the hospital?

Every child who stays over night in the hospital with an insulin pump or CGM must be seen by the endocrinologist.  This doctor specializes in diabetes and blood sugar control. They will talk to your child’s other doctors. This team will decide if the insulin pump or CGM can be used in the hospital. 

This team may decide that it is not safe to use a pump or CGM while in the hospital.  If it is not safe to use the insulin pump, your child will get insulin shots to control blood sugar. 

Insulin pumps and CGMs may also need to be removed if:

• your child is having surgery, a procedure, or any imaging, like an x-ray, CAT scan (CT), or MRI.  CGMs do not show accurate blood sugars during surgeries and procedures.
• removing the insulin pump helps keep the insulin pump and the skin around it safe. 

What are some things I need to do for my child to use an insulin pump or CGM while in the hospital?  

There are rules that must be followed.  These rules help keep your child safe while in the hospital.  Your nurses and doctors will explain these rules.  The insulin pump or CGM may be turned off if the rules are not followed.  Insulin shots will be given, instead. 

Hospital rules

• Someone who is trained to take care of the insulin pump or CGM must stay at the hospital 24 hours a day, 7 days a week.
• The person staying with your child must take care of the insulin pump and CGM while in the hospital.  They will fix any alarms and do all of the button pushing on the insulin pump and CGM.
• Your child cannot take care of the insulin pump or CGM while in the hospital, even if they are over 18 years old.
• If the person who takes care of the insulin pump or CGM needs to leave your child’s room for a short period of time, the person must:
  – tell the nurse.
  – give the nurse a cell phone number.
  – stay in the hospital.
  – be able to return to the room quickly.
• The person who takes care of the insulin pump cannot make changes to the insulin pump settings or give extra insulin without an order from the doctor.

Caregiver responsibilities

• The person who takes care of the insulin pump and CGM must:
• Have a doctor’s order to change insulin pump settings.
• Have a doctor’s order to give extra insulin.
• Show the insulin pump to 2 nurses: 
  – before giving an insulin bolus dose.
  – before and after changing the insulin pump settings. 
  – on admission. 
  – at shift change. 
  – as requested.

Tell the nurse if they are worried about signs of low or high blood sugar.  A hospital glucose meter will be used before giving any insulin.  Blood sugar levels from the CGM cannot be used to give insulin.

Bring 2 extra sets of insulin pump and CGM supplies. The supplies must be at the hospital within 12 hours of being admitted.