Implementing a Continuous Glucose Monitoring Hospital Discharge Program: Strategies and Best Practices

Abstract

Continuous glucose monitoring (CGM) has become the standard of care for outpatient diabetes management, yet its initiation during hospitalization—particularly at discharge—remains underutilized. The transition from hospital to home presents a unique opportunity to start CGM, educate patients, and improve glycemic outcomes. Although preliminary studies suggest that CGM initiation at discharge can increase time-in-range and reduce hypoglycemia and hospital readmissions, widespread adoption faces several challenges, including therapeutic inertia, patient selection, insurance barriers, and limited implementation guidance. At the time of this writing, CGMs are not yet US Food and Drug Administration-approved for inpatient use, but approval is anticipated. In this article, we present an actionable, stepwise protocol for CGM initiation at hospital discharge, developed by the Council for Clinical Excellence in Inpatient Diabetes at Johns Hopkins Medicine. The protocol includes multidisciplinary coordination, inclusive patient selection, structured education, designation of outpatient follow-up providers, and emphasis on consistent postdischarge care. We address common barriers such as impaired cognition during recovery and device compatibility with imaging studies. While further research is needed to confirm long-term cost-effectiveness and clinical outcomes, we believe our protocol can serve as a practical foundation for hospitals and providers seeking to safely and effectively integrate CGM initiation into discharge workflows.