Use of Continuous Subcutaneous Insulin Infusion (Insulin Pump) Therapy in the Hospital Setting: Proposed Guidelines and Outcome Measures

Purpose Individuals whose diabetes is being treated in the outpatient setting viaan insulin pump often wish to maintain this therapy during hospitalization.The authors propose guidelines for management of patients on insulin pumps whorequire a hospital admission. Methods A collaborative interinstitutional task force reviewed current availableinformation regarding the use of insulin pumps in the hospital. Results There was little information in the medical literature on how to manageindividuals on established insulin pump therapy during a hospital stay. Thetask force believed that a policy that promotes patient independence throughcontinuation of insulin pump therapy while ensuring patient safety waspossible. A set of contraindications for continued use of pump therapy in thehospital are proposed. A sample patient consent form and order set arepresented. Finally, measures that can be used to assess effectiveness of aninpatient insulin pump policy are outlined. Conclusions Patients on established insulin pump therapy do not necessarily have todiscontinue treatment while hospitalized. However, clear policies andprocedures should be established at the institutional level to guide continueduse of the technology in the acute care setting.