Continuous subcutaneous insulin infusion (insulin pump) therapy can be safely used in the hospital in select patients.
OBJECTIVE
To analyze data on inpatient insulin pump use and examine staff compliance with hospital procedures, glycemic control, and safety.


METHODS
We conducted a retrospective review of charts and bedside glucose data for patients who had been receiving outpatient insulin pump therapy and were admitted to our teaching hospital between November 1, 2005, and February 8, 2008.


RESULTS
During the study period, there were 50 hospitalizations involving 35 patients who had been receiving outpatient insulin pump therapy. The mean age and duration of diabetes of the 35 patients was 55 years and 32 years, respectively. Sixty-six percent were women, and 91% had type 1 diabetes. Patients in 31 of the hospitalizations (62%) were deemed candidates for continued insulin pump therapy during their stay. Of the 31 hospitalizations, 80% had the presence of the pump documented at admission; 100% had an admission glucose value; 77% had documentation of signed patient consent; 81% had evidence of completed preprinted insulin pump orders; 77% received an endocrine consultation; and 68% had a completed bedside flow sheet. Patients continuing insulin pump therapy had mean bedside glucose levels similar to those whose pump therapy was discontinued (P = .11); however, the proportion of hypoglycemic events was lower among insulin pump users (P<.01) than among nonusers.


CONCLUSIONS
Insulin pump therapy is safe for select inpatients. Overall, staff compliance with procedures was high, although we identified areas for improvement. Continued study is needed on the effectiveness of insulin pump therapy in controlling inpatient hyperglycemia.
Bailon
Rachel M
RM
Department of Internal Medicine, Mayo Clinic, Scottsdale, Arizona 85259, USA.
Partlow
Brenda J
BJ
Miller-Cage
Victoria
V
Boyle
Mary E
ME
Castro
Janna C
JC
Bourgeois
Peggy B
PB
Cook
Curtiss B
CB
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D004869:Equipment Safety; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D007297:Inpatients; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use*; D007332:Insulin Infusion Systems / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin