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Use of Continuous Subcutaneous Insulin Infusion (Insulin Pump) Therapy in the Hospital Setting

Proposed Guidelines and Outcome Measures

From the Division of Endocrinology (Dr Cook, Ms Boyle, Dr Roust), the Department of Nursing (Ms Cisar, Ms Miller-Cage), and the Department of Neurologic Surgery (Dr Zimmerman), Mayo Clinic, Scottsdale, Arizona, and Division of Endocrinology, Diabetes, Nutrition, and Metabolism and Department of Health Care Policy and Research, Mayo Clinic, Rochester.

Correspondence to Curtiss B. Cook, MD, Division of Endocrinology, Mayo Clinic Scottsdale, 13400 East Shea Boulevard, Scottsdale, AZ 85259.

Purpose

Individuals whose diabetes is being treated in the outpatient setting via an insulin pump often wish to maintain this therapy during hospitalization. The authors propose guidelines for management of patients on insulin pumps who require a hospital admission.

Methods

A collaborative interinstitutional task force reviewed current available information regarding the use of insulin pumps in the hospital.

Results

There was little information in the medical literature on how to manage individuals on established insulin pump therapy during a hospital stay. The task force believed that a policy that promotes patient independence through continuation of insulin pump therapy while ensuring patient safety was possible. A set of contraindications for continued use of pump therapy in the hospital are proposed. A sample patient consent form and order set are presented. Finally, measures that can be used to assess effectiveness of an inpatient insulin pump policy are outlined.

Conclusions

Patients on established insulin pump therapy do not necessarily have to discontinue treatment while hospitalized. However, clear policies and procedures should be established at the institutional level to guide continued use of the technology in the acute care setting.

The Diabetes Educator, Vol. 31, No. 6, 849-857 (2005)
DOI: 10.1177/0145721705281563


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