Hybrid closed-loop insulin pump technology can be safely used in the inpatient setting
Open accessAbstract
Background Hybrid closed-loop (HCL) systems, also known as automated insulin delivery systems, are a rapidly growing technology in diabetes management. Because more patients are using these systems in the outpatient setting, it is important to also assess inpatient safety to determine whether HCL use can be continued when those patients become hospitalized.Methods The records of patients using HCL technology on admission to our hospital between June 1, 2020, and June 30, 2021, were analyzed.Results The final analysis included 71 patients divided into 3 categories based on their pump use as an inpatient: (1) HCL users; (2) manual pump users; and (3) pump removed. All cohorts were similar in age, sex, race, hemoglobin A1C at admission, and in Medicare Severity Diagnosis Related Group. Pairwise comparisons indicated that patient-stay mean glucose levels, frequency of patient-specific hyperglycemic measurements, and frequency of hypoglycemic events were similar between all groups. No adverse events, particularly occurrences of diabetic ketoacidosis, pump site complications or infection, or equipment malfunction, were reported.Conclusion This preliminary case series review indicates that continued use of HCL technology in the hospital is safe. Moreover, glycemic control in HCL users was comparable with that in those using insulin pump with manual settings and those converted to basal-bolus insulin therapy.
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Data are emerging on inpatient use of AID systems and their challenges.
“Similarly, data are emerging on the inpatient use of AID systems and their challenges (277,296,297).”
From 7. Diabetes Technology: Standards of Care in Diabetes—2025 (2025) · cites this paper as [296]
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Six-Month Randomized, Multicenter Trial of Closed-Loop Control in Type 1 Diabetes
Brown, S. A., Kovatchev, B. P., Raghinaru, D., Lum, J. W., Buckingham, B. A., Kudva, Y. C., Laffel, L. M., Levy, C. J., Pinsker, J. E., Wadwa, R. P., et al. (2019) · New England Journal of Medicine · doi:10.1056/nejmoa1907863 · Cited by 1,030 · see citing works
Safety of a hybrid closed-loop insulin delivery system in patients with type 1 diabetes
Bergenstal, R. M., Garg, S., Weinzimer, S. A., Buckingham, B. A., Bode, B. W., Tamborlane, W. V., & Kaufman, F. R. (2016) · JAMA · doi:10.1001/jama.2016.11708 · Cited by 644 · see citing works
Garg, S. K., Weinzimer, S. A., Tamborlane, W. V., Buckingham, B. A., Bode, B. W., Bailey, T. S., Brazg, R. L., Ilany, J., Slover, R. H., Anderson, S. M., et al. (2017) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2016.0421 · Cited by 585 · see citing works
Tauschmann, M., Thabit, H., Bally, L., Allen, J. M., Hartnell, S., Wilinska, M. E., Ruan, Y., Sibayan, J., Kollman, C., Cheng, P., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)31947-0 · Cited by 440 · see citing works
Korytkowski, M. T., Muniyappa, R., Antinori-Lent, K., Donihi, A. C., Drincic, A. T., Hirsch, I. B., Luger, A., McDonnell, M. E., Murad, M. H., Nielsen, C., et al. (2022) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgac278 · Cited by 315 · see citing works
Continuous glucose monitors and automated insulin dosing systems in the hospital consensus guideline
Galindo, R. J., Umpierrez, G. E., Rushakoff, R. J., Basu, A., Lohnes, S., Nichols, J. H., Spanakis, E. K., Espinoza, J., Palermo, N. E., Awadjie, D. G., et al. (2020) · Journal of Diabetes Science and Technology · doi:10.1177/1932296820954163 · Cited by 170 · see citing works
Self-citationBally, L., Thabit, H., Kojzar, H., Mader, J. K., Qerimi-Hyseni, J., Hartnell, S., Tauschmann, M., Allen, J. M., Wilinska, M. E., Pieber, T. R., et al. (2017) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(17)30001-3 · Cited by 149 · see citing works
Consensus Statement on Inpatient Use of Continuous Glucose Monitoring
Wallia, A., Umpierrez, G. E., Rushakoff, R. J., Klonoff, D. C., Rubin, D. J., Golden, S. H., Cook, C. B., & Thompson, B. (2017) · Journal of Diabetes Science and Technology · doi:10.1177/1932296817706151 · Cited by 147 · see citing works
Self-citationHybrid closed‐loop therapy: Where are we in 2021?
Leelarathna, L., Choudhary, P., Wilmot, E. G., Lumb, A. N., Street, T., Kar, P. S., & Ng, S. M. (2020) · Diabetes Obesity and Metabolism · doi:10.1111/dom.14273 · Cited by 140 · see citing works
Barnard, K. D., Wysocki, T., Ully, V., Mader, J. K., Pieber, T. R., Thabit, H., Tauschmann, M., Leelarathna, L., Hartnell, S., Acerini, C. L., et al. (2017) · Journal of Diabetes Science and Technology · doi:10.1177/1932296817702656 · Cited by 131 · see citing works
Psychosocial impacts of hybrid closed‐loop systems in the management of diabetes: a review
Farrington, C. (2017) · Diabetic Medicine · doi:10.1111/dme.13567 · Cited by 123 · see citing works
Is an artificial pancreas (closed‐loop system) for Type 1 diabetes effective?
Boughton, C. K., & Hovorka, R. (2018) · Diabetic Medicine · doi:10.1111/dme.13816 · Cited by 105 · see citing works
Sharifi, A., de Bock, M. I., Jayawardene, D., Loh, M., Horsburgh, J. C., Berthold, C. L., Paramalingam, N., Bach, L. A., Colman, P. G., Davis, E. A., et al. (2016) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2016.0288 · Cited by 93 · see citing works
Sadhu, A. R., Serrano, I. A., Xu, J., Nisar, T., Lucier, J., Pandya, A. R., & Patham, B. (2020) · Journal of Diabetes Science and Technology · doi:10.1177/1932296820964264 · Cited by 84 · see citing works
Cook, C. B., Beer, K. A., Seifert, K. M., Boyle, M. E., Mackey, P., & Castro, J. C. (2012) · Journal of Diabetes Science and Technology · doi:10.1177/193229681200600502 · Cited by 80 · see citing works
Self-citationPatient Outcomes after Implementation of a Protocol for Inpatient Insulin Pump Therapy
Noschese, M. L., DiNardo, M. M., Donihi, A. C., Gibson, J. M., Koerbel, G. L., Saul, M. I., Stefanović-Račić, M., & Korytkowski, M. T. (2009) · Endocrine Practice · doi:10.4158/ep09063.orr · Cited by 73 · see citing works
Saunders, A. L., Messer, L. H., & Forlenza, G. P. (2019) · Expert Review of Medical Devices · doi:10.1080/17434440.2019.1670639 · Cited by 62 · see citing works
Yeh, T., Yeung, M., & Curanaj, F. A. M. (2021) · Current Diabetes Reports · doi:10.1007/s11892-021-01375-7 · Cited by 46 · see citing works
Consensus Statement on Use of Continuous Subcutaneous Insulin Infusion Therapy in the Hospital
Thompson, B., Korytkowski, M. T., Klonoff, D. C., & Cook, C. B. (2018) · Journal of Diabetes Science and Technology · doi:10.1177/1932296818769933 · Cited by 32 · see citing works
Self-citationEfficacy of Hybrid Closed-Loop Insulin Delivery System in a Hospital Setting: A Case Series
Atif, Z., Halstrom, A., Peragallo‐Dittko, V., & Klek, S. P. (2021) · AACE Clinical Case Reports · doi:10.1016/j.aace.2020.12.013 · Cited by 18 · see citing works
Lee, I., Liau, Y., Lee, W., Huang, C., & Sheu, W. H. (2010) · Journal of Evaluation in Clinical Practice · doi:10.1111/j.1365-2753.2009.01134.x · Cited by 12 · see citing works
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7. Diabetes Technology: Standards of Care in Diabetes—2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Echouffo-Tcheugui, J. B., Ekhlaspour, L., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s007 · Cited by 348 · see citing works
7. Diabetes Technology: <i>Standards of Care in Diabetes—2024</i>
American Diabetes Association Professional Practice Committee, ElSayed, N. A., Aleppo, G., Bannuru, R. R., Bruemmer, D., Collins, B. S., Ekhlaspour, L., Hilliard, M. E., Johnson, E. L., Khunti, K., et al. (2024) · Diabetes Care · doi:10.2337/dc24-s007 · Cited by 281 · see citing works
Zelada, H., Perez‐Guzman, M. C., Cherñavvsky, D. R., & Galindo, R. J. (2023) · Endocrine Connections · doi:10.1530/ec-23-0180 · Cited by 34 · see citing works
Hughes, M. S., Pasquel, F. J., Davis, G. M., Lal, R., Buckingham, B. A., Boughton, C. K., Brown, S. A., & Bally, L. (2024) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2024.0343 · Cited by 13 · see citing works
Recent advances in the precision control strategy of artificial pancreas
Ming, W., Guo, X., Zhang, G., Liu, Y., Wang, Y., Zhang, H., Liang, H., & Yang, Y. (2024) · Medical & Biological Engineering & Computing · doi:10.1007/s11517-024-03042-x · Cited by 12 · see citing works
Automated Insulin Delivery Technology in the Hospital: Update on Safety and Efficacy Data
Thompson, B., Boyle, M. E., Castro, J. C., Dodoo, C., & Cook, C. B. (2024) · Endocrine Practice · doi:10.1016/j.eprac.2024.07.012 · Cited by 11 · see citing works
Self-citationMüssig, K., Gallwitz, B., Haak, T., Kellerer, M., & Siegel, E. G. (2025) · Diabetologie und Stoffwechsel · doi:10.1055/a-2592-9700 · Cited by 4 · see citing works
Insights for personalized choice of a hybrid closed–loop system: an expert opinion
Molfetta, S. D., Boscari, F., Rossi, A., Girelli, A., Lepore, G., Bozzetto, L., Irace, C., Laviola, L., & Bruttomesso, D. (2026) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2026.113120 · Cited by 4 · see citing works
Comparison of Metabolic Control in Children and Adolescents Treated with Insulin Pumps
Lejk, A., Myśliwiec, K., Michalak, A., Pernak, B., Fendler, W. M., & Myśliwiec, M. (2024) · Children · doi:10.3390/children11070839 · Cited by 4 · see citing works
Inpatient Use of Automated Insulin Delivery Systems
Chadalawada, L., Parab, R., Feeley, J. M., Hughes, M. S., Pasquel, F. J., & Davis, G. M. (2026) · Journal of Diabetes Science and Technology · doi:10.1177/19322968251412442 · Cited by 3 · see citing works
Artificial Intelligence for Diabetes in the Hospital
Sly, B. P., Shrapnel, S., & Sullivan, C. M. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-13244-5.00021-3 · Cited by 1 · see citing works
Cook, C. B., Thompson, B., Perrin, A. J., Castro, J. C., McGary, A. K., & Buras, M. R. (2025) · Endocrine Practice · doi:10.1016/j.eprac.2025.09.200 · Cited by 1 · see citing works
Self-citationRuprai, B., Catania, S., Berati, V., Halperin, I. J., Malcolm, J., Liu, S., Houlden, R. L., & Spaic, T. (2026) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2026.03.002 · Cited by 1 · see citing works
Singh, G., Vamvini, M. T., & Toschi, E. (2025) · Springer eBooks · doi:10.1007/978-3-031-86099-7_27
Redefining inpatient diabetes care: A policy-driven approach to safe and effective technology use
Holliday, M. E., Herbert, L., & Kubas, J. (2025) · Journal of the American Association of Nurse Practitioners · doi:10.1097/jxx.0000000000001209 · Cited by 1 · see citing works
Galasso, S., Piccini, S., Casarsa, V., Agus, S., & Porto, A. D. (2025) · Cureus · doi:10.7759/cureus.96075
Insulin pumps and artificial pancreas
Markakis, K. P., & Vazeou, A. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-13825-6.00296-x
Müssig, K., Gallwitz, B., Haak, T., Kellerer, M., & Siegel, E. G. (2026) · Die Diabetologie · doi:10.1007/s11428-026-01424-3
On-demand radiofrequency-controlled drug release from microcapsule depot in ex vivo tissue model
Slonková, K., Navrátil, O., Huňa, R., Dolenský, B., Lizoňová, D., & Štĕpánek, F. (2026) · International Journal of Pharmaceutics · doi:10.1016/j.ijpharm.2026.127115
Cunningham, H., Jenkins, A., O'Neal, D. N., & Lee, M. H. (2026) · Diabetic Medicine · doi:10.1111/dme.70372
Amouyal, C., Benhamou, P., Carlier, A., Marchand, L., Smati, S., & Villard, O. (2026) · Médecine des Maladies Métaboliques · doi:10.1016/j.mmm.2026.06.008
Real-World Outcomes of Automated Insulin Delivery Use in Hospitalized Adults With Diabetes
Ruddiman, K. R., Evans, J. K., Aloi, J., Usoh, C. O., & Price, C. E. (2026) · Journal of Diabetes Science and Technology · doi:10.1177/19322968261473583
Olsen, M. T., Spanakis, E. K., Thabit, H., Dhatariya, K., Mustafa, O. G., Avari, P., Lumb, A. N., Dungan, K. M., Philis‐Tsimikas, A., Kulasa, K. M., et al. (2026) · Diabetologia · doi:10.1007/s00125-026-06838-8
The Use of Diabetes Technology in the Inpatient Setting
Akcan, T., Faulds, E. R., Lal, R., Davis, G. M., Brown, S. A., Pasquel, F. J., & Hughes, M. S. (2026) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2026.08.016
Diabetes im Krankenhaus – Praxisempfehlung der DDG
Müssig, K., Gallwitz, B., Haak, T., Kellerer, M., & Siegel, E. G. (2026) · Diabetologie und Stoffwechsel · doi:10.1055/a-2884-3481
- Authors
- Pelkey, M. N., Boyle, M. E., Long, A., Castro, J. C., Cook, C. B., & Thompson, B.
- Affiliations
- Mayo Clinic (US)
- Mayo Clinic in Arizona (US)
- Corresponding author
- Pelkey, Melissa N.
- Venue
- Endocrine Practice
- Publisher
- Elsevier BV
- Published
- 2023-01
- Volume
- 29
- Issue
- 1
- Pages
- 24-28
- ISSN
- 1530-891X (ISSN-L)
- OpenAlex
- W4309103228
- Cited by
- 25
- References
- 21
- Citations by year
- 2026: 11 · 2025: 6 · 2024: 6 · 2023: 2
- FWCI
- 2.59
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Endocrine Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- hybrid closed-loop insulin pump, artificial pancreas, inpatient diabetes management, hospitalized patients, glycemic control, hypoglycemia, hyperglycemia, diabetic ketoacidosis, multiple daily insulin injections
- MeSH terms
- Aged, Blood Glucose, Diabetes Mellitus, Type 1, Medicare, Humans, Hypoglycemic Agents, Inpatients, Insulin, Insulin Infusion Systems, Technology, United States, Blood Glucose Self-Monitoring
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