CGM Use in Hospitals Helps Patients and Nurses – diaTribe Foundation

People with diabetes who are hospitalized often face challenges if they use continuous glucose monitoring. Hospital staff may not be familiar with different CGM devices, or may not know how to use them for insulin dosing. And while CGM use in a hospital setting isn't currently approved by the FDA, new research shows that patients benefit from using their own devices, which could be influential in moving away from finger sticks as the standard.

Researchers from Stanford Health Care developed a hospital-wide plan for CGM use for insulin dosing, in a study in 2022 to 2023. The results showed CGM use was effective for patients, with 87.7% success meeting the accuracy criteria for insulin dosing. About 1,500 CGM readings from 135 patients using their personal CGM were validated using a finger stick test. Study results were presented at the 2024 American Diabetes Association Scientific Sessions in Orlando.

Dr. Susan Seav, an endocrinology fellow at Stanford Medicine, and the other researchers in the study developed a chart that nurses could use for making dosing decisions for the majority of hospital patients they treated, who were using Dexcom and Libre sensors.

"We think that the creation and implementation of an inpatient CGM protocol with real-time device accuracy monitoring is feasible and allows for insulin dosing based on personal CGM data," Seav said. "By sharing our experience and our data, we really hope to establish CGM use as part of the standard of care when appropriate. And we also want to encourage and empower other institutions to adopt similar protocols."

The study also found that a large majority of nurses 80% preferred CGM use to finger sticks. And most nurses found inpatient CGM use effective, easy to use, and efficient.

"The ADA has said people should, if at all possible, be allowed to continue to use their CGM right in the hospital," said Dr. Nicholas Argento, diabetes technology director at Maryland Endocrine and Diabetes, who attended a presentation of the study but was not involved in it. "But hospitals need to have a protocol in order to allow this. In this study, the accuracy was excellent."

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CGM Use in Hospitals Helps Patients and Nurses - diaTribe Foundation