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"/>

Information for Healthcare Providers:
Dexcom G6 CGM System in the Hospital

On April 1, 2020, the Federal Drug Administration (FDA) notified Dexcom that it is exercising its enforcement discretion and will not object to the use of continuous glucose monitoring (CGM) systems for the treatment of patients in hospital settings and other healthcare facilities to support COVID-19 healthcare-related efforts during the current pandemic. This does not expand Dexcom’s current authorized indications for use for its home use product.

 

Extending use of the Dexcom CGM systems to hospitalized patients during the COVID-19 emergency in order to allow hospital staff to remotely monitor glucose in patients may reduce provider/patient interaction, limiting viral exposure by hospital staff, and conserve personal protective equipment.

 

However, the Fact Sheet for Healthcare Providers should be reviewed carefully before using the Dexcom CGM systems in hospital settings.

FDA Grants Breakthrough Device Designation for Dexcom Hospital CGM System

Dexcom CGM for use in the hospital setting was granted FDA Breakthrough Device Designation. The Breakthrough Device program is designed to expedite the development and regulatory review of medical devices that hold the potential for more effective treatment of life-threatening or irreversibly debilitating disease or condition.

 

This does not expand Dexcom’s current authorized indications for use of its home use product.

 

View the Press Release

Dexcom G6 in the Hospital Setting

Watch and learn more about the value and use of CGM in the hospital.

Overview of Dexcom G6

Clinical Use of CGM

Clinical Evidence


Review evidence demonstrating the impact that CGM use can have on glucose management in hospital.

Real-Time CGM in Intensive Care Units

Use and Accuracy of Inpatient CGM During the COVID-19 Pandemic: An Observational Study of General Medicine and ICU Patients
Longo RR et al. Journal of Diabetes Science and Technology. May 2021

Implementation of a Continuous Glucose Monitoring Program at a Safety Net Hospital During Covid 19 Pandemic
Finn EE et al. Journal of the Endocrine Society. April-May 2021

Continuous Glucose Monitoring in the Operating Room and Cardiac Intensive Care Unit
Perez-Guzman MC et al. Diabetes Care. 2021 Mar; 44(3): e50-e52.

Facilitators and Barriers to Nursing Implementation of Continuous Glucose Monitoring in Critically Ill COVID-19 Patients
Faulds ER et al. Endocrine Practice. 2021 Jan; 27(4):354–61.

Outcomes and Healthcare Provider Perceptions of Real-Time Continuous Glucose Monitoring (rtCGM) in Patients with Diabetes and COVID-19 Admitted to the ICU
Chow KW et al. Journal of Diabetes Science and Technology. Jan 2021; 1932296820985263

Continuous Glucose Monitoring in the Intensive Care Unit During the COVID-19 Pandemic
Agarwal S et al. Diabetes Care. 2020 Dec; 2021;44(3):847-849.

Continuous Glucose Monitoring in Critically Ill Patients with COVID-19: Results of an Emergent Pilot Study
Sadhu AR et al. Journal of Diabetes Science and Technology. 2020; 14(6):1065-1073.

Real-Time CGM in Non-Intensive Care Units

Accuracy of Dexcom G6 Continuous Glucose Monitoring in Non-Critically Ill Hospitalized Patients With Diabetes
Davis GM et al. Diabetes Care. June 2021

Use and Accuracy of Inpatient CGM During the COVID-19 Pandemic: An Observational Study of General Medicine and ICU Patients
Longo RR et al. Journal of Diabetes Science and Technology. May 2021

Reducing Inpatient Hypoglycemia in the General Wards Using RealTime Continuous Glucose Monitoring: The Glucose Telemetry System, a Randomized Clinical Trial
Singh LG et al. Diabetes Care. 2020;43(11):2736-2743

Glucose as the Fifth Vital Sign: A Randomized Controlled Trial of Continuous Glucose Monitoring in a Non-ICU Hospital Setting
Fortmann AL et al. Diabetes Care. 2020;43(11):2873-2877.

Feasibility of Inpatient Continuous Glucose Monitoring During the COVID-19 Pandemic: Early Experience
Reutrakul S et al. Diabetes Care. 2020;43(10):e137-e138.

A Pilot Study of the Feasibility and Accuracy of Inpatient Continuous Glucose Monitoring
Nair BG et al. Diabetes Care. 2020;43(11):e168-e169.

Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes
Baker M et al. American Journal of Health-System Pharmacy, Volume 79, Issue 6, 15 March 2022
Listen to the Podcast

 

Resource

Hospital Fact Sheet for Healthcare Providers

Information Request for Healthcare Providers

Complete this form to learn more about using Dexcom G6 in the hospital, including meeting with our team and ordering product for the hospital.

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