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 I diabetes. Patients in 3 1 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. (Endocr Pract. 2009;15:24-29)