Home Insulin Pump Use in Hospitalized Children With Type 1 Diabetes
Authors' conclusion
In this cohort study, home insulin pump use was found to be safe in a children's hospital regarding hyperglycemia and hypoglycemia. These data support use of home insulin pumps during pediatric admissions in patients who do not require intensive care and without active DKA.
Study context
- Population
- Hospitalized children with insulin-dependent diabetes (primary or secondary diagnosis on admission), tertiary children's hospital, 2016–2021; aged 0.5 to 25 years, median age 15.8 years (IQR 12.3–18.3)18,096 insulin-days
- Participants
- 2,738 children
- Exposure
- Home insulin pump vs hospital insulin pump vs subcutaneous injection
- Home pumpsn = 775
- Hospital pumpsn = 990
- Outcome
- Hyperglycemia (glucose >250 mg/dL) and hypoglycemia (glucose <45 mg/dL) rates as proportion of total insulin-days, glucose variability, and DKA recurrences
Methodological detailssingle-centre, observational
- Single-centre
- Observational
Main finding
As reported in the abstract
Hyperglycemia (glucose >250 mg/dL), proportion of insulin-days
P < 0.001
Observational data: associations, not effects.
Safety
| Outcome | Injections | P value |
|---|---|---|
| Moderate hypoglycemia, proportion of insulin-daysBetween Hospital pump and Injections · across hospital pump, home pump and injections | 5.1% | P = 0.02 |
| DKA | 0.01% |
- Moderate hypoglycemia, proportion of insulin-days: Hospital pump 3.1%
- Moderate hypoglycemia, proportion of insulin-days: Home pump 4.5%
- Diabetic ketoacidosis (DKA): Hospital pump 0 events
- DKA: Home pump 0 events
Severe hypoglycemia
- Did not differ significantly by insulin delivery method
Original publication
Home Insulin Pump Use in Hospitalized Children With Type 1 Diabetes. JAMA Netw Open. Published 5 February 2024. doi:10.
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