We do stat fingersticks on diabetics with symptoms (such as dizzy, increased urination, etc). If we get a pt who is confused, has a decreased level of consciousness, is having seizures, etc - then we get a stat fingerstick too. If the pt is at the ED for a med refill, their blood glucose may not be checked. This may sound sad, but some ED docs hate it when we go "fishing" because if the pt's fingerstick is way off, then the doc has to treat it (and I'm not saying that that's the right thing to do, either).
If we have a pt being admitted with a history of diabetes, we definately get a baseling blood glucose. If their admission is unrelated to diabetes, we may or may not recheck their blood sugar before they go up to the floor (depends on the length of time they're in the ED). Most often, our ED docs will permit a pt to eat but won't start giving them insulin because they don't want to be chasing low blood sugars on a pt with a bed waiting upstairs and an admitting doc already writing orders for the floor.
The only time we give insulin is if the person is in DKA or if their blood glucose is way too high (or if the pt's potassium is sky high, but that's a whole different story).
Things can change so fast in the ED; one minute you have time to check a blood sugar, and the next minute you have the hall beds full with a PNB 5 minutes out. Increased blood sugar after eating is not a priority at that point in a pt who is asymptomatic.
We truly do some amazing things each day in the ED. It seems like ICU and floor nurses hate the way we do things in the ED - but truly, we start with a blank slate and work our way up and do our best to patch the pt up before transfering them to a different department. The other night, I was treated like dirt by some ICU nurses after transfering a head bleed pt; he was very hypertensive, confused; I was 1:1 with him and went to CT with him, worked on managing his BP and educating the family, I got his old records faxed from a different hospital, gathered his med list to the best of my ability, placed another IV, removed a different IV that he had pulled out, prepared for intubation, placed a third IV, labeled my IV lines - and when I brought him to ICU and passed his copied chart to the nurse, I said "I've also included his records from xyz hospital" - I was ignored and they slammed the door in my face. So, I turned around and ran back to the ED to see how my other 4 pts were doing, only to be placed with another head bleed ready to go to the OR...