Home insulin pump use in hospitalized children with type 1 diabetes
Open accessAbstract
Importance: Pediatric data on inpatient home insulin pumps are absent in the literature. Understanding safety of home insulin pumps, managed by patients or caregivers, during times of illness will help diabetes technology securely move into pediatric hospitals. Objective: To examine whether insulin can be safely and accurately delivered to hospitalized children through home insulin pumps when managed by patients or caregivers. Design, Setting, and Participants: This single-center, retrospective, observational cohort study included children with insulin-dependent diabetes admitted to a tertiary children’s hospital from January 1, 2016, to December 31, 2021. In all these patients, diabetes was the primary or secondary diagnosis on admission. Exposure: Insulin delivery via home insulin pump, hospital insulin pump, or subcutaneous injection. Main Outcomes and Measures: Hyperglycemia (glucose, >250 mg/dL) and hypoglycemia (glucose, <45 mg/dL) rates (quantified as the proportion of total insulin-days), glucose variability, and diabetic ketoacidosis (DKA) recurrences were compared for hospital pumps (manual mode), home pumps (manual mode), and subcutaneous injections using bivariate tests. Results: There were 18 096 insulin-days among 2738 patients aged 0.5 to 25 years (median age, 15.8 years [IQR, 12.3-18.3 years]). Overall, 990 (5.5%) of insulin-days involved hospital insulin pumps, and 775 (4.3%) involved home pumps. A total of 155 insulin-days (15.7%) involving hospital pumps were hyperglycemic, compared with 209 (27.0%) involving home pumps and 7374 (45.2%) involving injections (P < .001). Moderate hypoglycemia days comprised 31 insulin-days (3.1%) involving hospital pumps compared with 35 (4.5%) involving home pumps and 830 (5.1%) involving injections (P = .02). Severe hypoglycemia did not differ significantly according to insulin delivery method. Two patients using injections (0.01%) developed DKA; no patients using hospital or home pumps developed DKA. Conclusions and Relevance: 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.
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An observational study in children demonstrated improvement in individual satisfaction and improved detection of glycemic excursions with continued use of personal devices.
“An observational study in children demonstrated improvement in individual satisfaction and improved detection of glycemic excursions with continued use of personal devices (60).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [60]
The Methods describe a retrospective study of hospitalized children using home insulin pumps, and the Discussion reports fewer hyperglycemic and hypoglycemic days with home pumps than with injections (page not provided). The paper does not report improved individual satisfaction or test whether personal devices improved detection of glycemic excursions; it measured glucose outcomes instead. (LLM, conf=0.88)
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16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s016 · Cited by 80 · see citing works
- Authors
- Owens, J., Courter, J., Schuler, C. L., Lawrence, M., Hornung, L., & Lawson, S.
- Affiliations
- Cincinnati Children's Hospital Medical Center (US)
- Corresponding author
- Lawson, Sarah
- Venue
- JAMA Network Open
- Publisher
- American Medical Association (AMA)
- Published
- 2024-02-07
- Volume
- 7
- Issue
- 2
- Pages
- e2354595
- ISSN
- 2574-3805 (ISSN-L)
- PMC
- PMC10851090
- OpenAlex
- W4391598120
- Cited by
- 5
- References
- 3
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1
- FWCI
- 1.65
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JAMA Network Open (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Keywords
- type 1 diabetes, hospitalized children, subcutaneous insulin injection, hypoglycemia, hyperglycemia, glycemic variability, diabetic ketoacidosis, diabetes technology, pediatric hospitalization
- MeSH terms
- Adolescent, Child, Child, Hospitalized, Diabetes Mellitus, Type 1, Glucose, Hospitals, Pediatric, Humans, Hyperglycemia, Hypoglycemia, Insulin, Retrospective Studies, Cohort Studies, Diabetic Ketoacidosis, Insulin, Regular, Human
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