CGMs

Good morning Kristie. While I have not been asked to do this...yet, I know it will be coming on the horizon. I was able to attend a scientific session at the annual ADLM meeting 2025 that covered this topic in greater depth. Yes, other hospitals are doing this already and their plan does sound like your soon to be policy. If I remember correctly, there was a daily requirement to match one of the hospital meters within a specific percentage. I do not remember if 20% was the guideline. If it matched, then the patient was good to go using their CGM. If it did not match, then they were not.  I would think that an auto calculation would need to be in place for this to work. I remember there was a whole policy created that also required a daily visual check of the CGM for things like proper placement and any signs of infection too. Hopefully, someone who has already tackled this will reach out to you.

Our lab leadership fought and won posting CGM results under the lab section of the EMR. Since there is no lab oversight of these meters, we could not assure that the results are correct. Per hospital policy, the nursing staff must monitor and take action (i.e. check glucose with a POCT glucose meter) when certain conditions arise. There is an EMR location that the CGM results are recorded.

We were asked to do this and were able to argue successfully against implementation.  For our institution, treatment decisions can only be made using our hospital approved glucometers (especially great for our inpatient population given that cgm lags behind wbg in rapid change in glucose level).  We do not record results or make treatment decisions from any patient owned monitoring device.

I don't see this (CGM in the inpatient hospital setting) becoming widely implemented unless the cost difference between cgm and wbg decreases and accuracy with cgm greatly increases.  I could see this being harder to argue against in the outpatient only setting (especially if the cost decreases, leading to more patients using them), but I would still argue that if the patient were my child/family member that I would want a gold standard/accurate vs a "probably good enough" result.

I'd recommend looking up any current literature to see what is trending (I doubt any of us have the time to do so....but wishful thinking).  Happy Holidays