Real-World Outcomes of Automated Insulin Delivery Use in Hospitalized Adults With Diabetes
Kathleen R. Ruddiman, Joni K. Evans, Joseph A. Aloi, Chinenye Usoh, Catherine PriceBackground:
Automated insulin delivery (AID) systems are increasingly used by individuals living with diabetes in the outpatient setting, but data on their safety and effectiveness during hospitalizations remains limited. The objective is to evaluate the use and efficiency of AID systems in hospitalized adults with diabetes.
Methods:
We performed a retrospective cohort study based on electronic health record data from hospital admissions of 316 patients with diabetes using insulin pumps. Automated insulin delivery and continuous glucose monitor use, insulin pump continuation, length of stay (LOS), and glycemic outcomes among the cohort were analyzed. The primary aims of the study were to describe rates of insulin pump continuation and reasons associated with removal, and rates of pump reinitiation. Secondary outcomes included effects of insulin pump removal and prompt endocrinology consultation on inpatient glycemic outcomes and LOS.
Results:
Insulin pumps were continued in 64.2% of all admissions. The most common reason for pump discontinuation was surgery (30.1%). Length of stay was longer when pumps were removed (8.3 vs 4.7 days,
Conclusions:
Continuation of insulin pumps was associated with improvement in hyperglycemia without increased hypoglycemia risk and with shorter LOS in the hospital. Standardized institutional policies including prompt glycemic management team consultation may help expand safe continuation of AID during hospitalizations.