DexCom Continuous Glucose monitoring

We told the staff that we can't use it because it has not been validated by our hospital.  Similarly we wouldn't let a patient use their home meter to test themselves while inpatient at the hospital.  Even though it is a waived test, it is still under our CLIA/CAP license so we are responsible for managing it.

We did encounter this.  Our final decision was that while under the care of our facility that glucose checks must be performed using our hospital meters.  There was no place to document if the patient's monitoring device was used.  Plus, we run daily QC on our meters, along with proficiency testing and linearities twice a year to ensure our meters are producing accurate results while we cannot guarantee the accuracy of the continuous monitoring device.  We do have a hospital wide policy on the use of Personally Owned Medical Equipment that says we can’t use them if we have a piece of equipment comparable to use.  Luckily there was a group involved that agreed on only using the hospital approved glucometers for patient care.   Hope this helps!

From what I have read, the CGM devices measure the interstitial fluid not whole blood.  CGM measurements are usually 5-10 minutes behind so if treatment is based on those values, you may be treating inaccurately, because the value is not in real time.  
We do not allow treatment based on anything other than our hospital approved meters.

This came up recently for us too.  My response was "neither the Freestyle Libre 3 or the Dexcom G6 are currently FDA approved for use in a hospital setting. This means we cannot use them to guide any decisions or even as a screening tool.  In April 2020 the FDA exercised enforcement discretion and would not object to use of CGM systems for treatment of patients in hospital settings during the pandemic.  So some health systems were using them in their isolation rooms, but we cannot use them on our general hospitalized patients until the FDA approval is expanded."  

I looped our Diabetes Nurse Navigator into the conversation and she backed me up stating, "I looked at the 2023 ADA Standards Of Care. You are correct in that use of CGM’s is not FDA approved yet. It does mention that some hospitals are using them (must have an established glucose management team which we do not have) but that it is absolutely not recommended for critical care.

 You can read the ADA’s guidance on CGM use in the ADA Standards Of Care 2023 under Diabetes Care In The Hospital: Blood Glucose Monitoring. "

Hope that helps.  Once these are FDA approved for hospital settings, I'm curious how hospital labs will manage these.  We didn't use them during COVID.

Thank  you guys for your response.  I am overwhelmed with gratitude on the amount of help.  I am going to share this with our nursing supervisor and quality program managers.