iCoDE-2 Standard Project Join iCoDE 2Press Release

Overview

The Integration of Connected Diabetes Device Data into the Electronic Health Record (iCoDE-2) Project is a consortium whose purpose is to facilitate efficient uploading and integration of insulin delivery data into the EHR. The two goals of the iCoDE-2 project are to (1) develop technical specifications to integrate insulin delivery data into the EHR, and (2) develop workflows and guidelines to facilitate data integration efforts.

iCoDE-2 was conceived and organized between 2023 and 2025 by project leadership in partnership with the Diabetes Technology Society. The project was developed by a cross-disciplinary, international steering committee representing healthcare, manufacturing, information technology, regulation, and policy. The result of this work is the 2025 iCoDE Report: EHR integration Standards and Recommendations for Insulin Delivery Data.

What’s new in the 2025 report:

• A FHIR-first interoperability strategy is recommended for insulin delivery data exchange (with HL7 v2 used when FHIR is not feasible/appropriate).
• A strong emphasis on patient data rights and autonomy, including patient-visible controls (including “disconnect”), notification of cloud-sourced access, and auditable/revocable account linkage.
• Standardized approaches to clinical workflows and insulin data visualization, including the Insulin Dosing Profile (IDP).
• 41 formal recommendation statements to guide implementation and strategic decision making.

Who this report is for:

This report provides technical and practical guidance to support development and implementation of insulin device data integrations with the EHR. It is intended for clinical champions, administrators, IT leaders, and project managers directly involved in integration efforts. It contains significant technical detail, but is not intended to be a stand-alone technical guide; local expertise and collaboration with third parties (manufacturers, aggregators, integrators) will still be required.

How the report is organized

• Part 1 describes the project background, organization, process, and key concepts/definitions.
• Part 2 contains detailed technical information, including the canonical insulin data model and current approaches to integration.
• Part 3 covers insulin data visualization and clinical implementation.
• Part 4 summarizes the formal recommendations adopted by the iCoDE Steering Committee, including the voting process and results. 
• The Appendix contains references, full membership, acknowledgements, and funding information.

Attribution

The 2025 iCoDE Report: EHR integration Standards and Recommendations for Insulin Delivery Data was prepared by:

Juan C. Espinoza, David C. Klonoff, Simona Carini, Viral N Shah, Alaina P Vidmar, Sarah D Corathers, Mark Clements, Eric Williams, Lawrence Lett, Ashley DuNova, Agatha F Scheideman, Mandy M Shao.

Suggested citation in AMA format: Espinoza J, Klonoff D, Carini S, et al. 2025 iCoDE Report: EHR integration Standards and Recommendations for Insulin Delivery Data. Diabetes Technology Society. https://diabetestechnology.org/icode2. Published December 30th, 2025. Accessed [date].

Downloads

You can download the 2025 iCoDE Report: EHR integration Standards and Recommendations for Insulin Delivery Data for free here.

Current version: 1.0, released December 30th, 2025

Feedback, Comments, and Updates

• Found spelling, formatting, factual errors, or other corrections? Suggestions to improve the writing and concepts? Questions about integration implementation? Want to join or support iCoDE? Let us know here.

iCoDE and iCoDE-related publications

1. Scheideman AF, Shao MM, Carini S, Shah VN, Vidmar AP, Corathers SD, Williams E, Lett L, Clements M, Klonoff DC, Espinoza J. iCoDE-2 September 18, 2025 Steering Committee Final Meeting Summary Report. J Diabetes Sci Technol. 2025 Oct 21:19322968251391823. doi: 10.1177/19322968251391823. Epub ahead of print. PMID: 41121532.

2. Aaron RE, Tian T, Yeung AM, Huang J, Klonoff DC, Espinoza JC. The Launch of the iCoDE-2 Standard Project: Integration of Connected Diabetes Device Data Into the Electronic Health Record. J Diabetes Sci Technol. 2024 Jan;18(1):82-88. doi: 10.1177/19322968231207888. Epub 2023 Oct 18. PMID: 37850590; PMCID: PMC10899851.

3. Espinoza JC, Yeung AM, Huang J, Seley JJ, Longo R, Klonoff DC. The Need for Data Standards and Implementation Policies to Integrate Insulin Delivery Data Into the Electronic Health Record. Journal of Diabetes Science and Technology. 2023;0(0). doi:10.1177/19322968231178549

4. Juan C. Espinoza, David C. Klonoff, Alaina P. Vidmar, Maurice Tut, Sarah Corathers, Randi Seigel, Andrea M. Yeung, Nicole Y. Xu, Payal Shah, Mahsa Babaei, Jingtong Huang, Kevin T. Nguyen, Julian Goldman, Shahid Shah. 2022 iCoDE Report: CGM-EHR Integration Standards and Recommendations. Diabetes Technology Society. https://www.diabetestechnology.org/icode/. Published November 7th, 2022.

5. Yeung AM, Huang J, Klonoff DC, Seigel RE, Goldman JM, Shah SN, Corathers SD, Vidmar AP, Tut M, Espinoza JC. iCoDE June 22, 2022 Steering Committee Meeting Summary Report. J Diabetes Sci Technol. 2022 Aug 29:19322968221119146. doi: 10.1177/19322968221119146. Epub ahead of print. PMID: 36036511.

6. Xu NY, Nguyen KT, DuBord AY, Klonoff DC, Goldman JM, Shah SN, Spanakis EK, Madlock-Brown C, Sarlati S, Rafiq A, Wirth A, Kerr D, Khanna R, Weinstein S, Espinoza J. The Launch of the iCoDE Standard Project. J Diabetes Sci Technol. 2022 Jul;16(4):887-895. doi: 10.1177/19322968221093662. Epub 2022 May 9. PMID: 35533135; PMCID: PMC9264445.

7. Espinoza J, Xu NY, Nguyen KT, Klonoff DC. The Need for Data Standards and Implementation Policies to Integrate CGM Data into the Electronic Health Record. J Diabetes Sci Technol. 2021 Nov 20:19322968211058148. doi: 10.1177/19322968211058148. Epub ahead of print. PMID: 34802286.

Funding

The iCoDE project was supported by grants to the Diabetes Technology Society from the following organizations (in alphabetical order):

1. Abbott Laboratories
2. Beta Bionics, Inc.
3. Dexcom, Inc.
4. Eli Lilly and Company
5. EOFlow Co., Ltd.
6. GlucoTrack, Inc.
7. Glytec, LLC
8. Insulet Corporation
9. Medtronic plc
10. Novo Nordisk
11. Sanofi
12. Sequel Med Tech, LLC
13. Tandem Diabetes Care
14. Terumo
15. Ypsomed

© 2025, Diabetes Technology Society. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/ or send a letter to Creative Commons, PO Box 1866, Mountain View, CA 94042, USA.