Home Insulin Pumps Safe for Hospitalized Children

A patient and provider doing a high five.

Home Insulin Pumps Safe for Hospitalized Children

Study shows family managed insulin pumps provide safe, effective glucose control for hospitalized children with diabetes.

Refer a Patient

Subspecialist On-Call1-888-987-7997

News and InnovationSubscribe to E-Newsletter

Key Takeaways

Home insulin pumps are safe for hospitalized children outside of intensive care settings.
Allowing home pump use minimizes injections, provides treatment continuity and engages families.
The study provides a foundation for future research on automated insulin delivery systems in hospitals.

Study Confirms Safety of Home Insulin Pumps for Hospitalized Children

For years, people with Type 1 diabetes and their families have advocated for the use of home insulin pumps during hospital stays.

"The majority of adult and pediatric patients diagnosed with Type 1 diabetes eventually choose home insulin pump therapy,” explains Sarah Lawson, MD, inpatient medical director for Endocrine and Diabetes at Cincinnati Children’s. “So, when they come into the hospital for non-endocrine reasons, they want and expect to keep using their home equipment."

However, hospitals have been cautious about allowing this practice due to national regulatory guidelines and in-house safety concerns about high-risk medications like insulin. A study from Cincinnati Children's provides reassuring evidence that using home insulin pumps is safe for hospitalized children outside of intensive care settings.

Data Analysis Reveals Positive Outcomes

The research team—including Lawson and Josh Courter, PharmD, pharmacy clinical coordinator for Acute Care at Cincinnati Children’s—analyzed data from over 2,700 pediatric patients and nearly 18,100 insulin days. Researchers compared outcomes for patients using hospital insulin pumps managed by staff, home pumps managed and operated by patients or caregivers, and traditional subcutaneous insulin injections.

The findings were clear. Hyperglycemic days were significantly lower for both hospital pumps (15.7%) and home pumps (27%) compared to injections (45.2%). Moderate hypoglycemia was also reduced with pumps. No patients using home pumps developed diabetic ketoacidosis (DKA) during their admissions.

The study analyzed data from over 2,700 pediatric patients and nearly 18,100 insulin days, showing significantly lower hyperglycemic days for both hospital pumps (15.7%) and home pumps (27.0%) compared to injections (45.2%).

Implications for Patient and Family Engagement

Beyond the clinical data, the study reinforces the importance of engaging patients and families in care management during hospitalization. As Lawson notes, "This is a great launching pad for moving towards the implementation of allowing home automated insulin delivery systems during hospitalizations."

Allowing home pump use minimizes injections, provides treatment continuity, engages families and creates opportunities to optimize pump settings. Courter adds, "Patients might actually be better off if they're able to use their home devices in areas with limited diabetes resources."

A Safe Solution for Pediatric Inpatients

The team found that families could safely operate pumps even on non-diabetes units by following hospital policies, reporting insulin doses and demonstrating basic pump competency. Nursing education was critical, with all staff receiving general diabetes management training.

The researchers emphasize that appropriate hospital policies, staff training and safety protocols are essential. However, the findings suggest the benefits of home pump use outweigh the risks when proper safeguards are in place.

Looking Forward: Automated Insulin Delivery Systems

Building on the success of home pump use, the Cincinnati Children's team is exploring ways to safely incorporate emerging automated insulin delivery systems into inpatient care. These devices connect insulin pumps with continuous glucose monitors, automatically adjusting insulin doses based on real-time glucose levels.

"If we hadn't seen home pumps work, we wouldn't be able to trust the automated systems and move towards getting the automated systems in the hospital setting," Lawson says.

The study shows that hospitals can rely on pumps managed by families—an essential first step.

Addressing Challenges and Moving Forward

This research addresses a notable gap in the pediatric literature and guides institutions looking to implement family-managed home pump policies. However, challenges remain. Many hospitals lack endocrinology resources or dedicated diabetes staff. Training all nursing staff on a wide array of pump models is impractical.

"We have to have a great team to work with,” says Courter. “We have a pharmacist, a physician and an expert in nursing education who have been crucial in developing the education and rolling this out to a wider population.”

The next phase involves testing automated insulin delivery systems, with a trial starting on three hospital units. "We've taken about six months to write up a new protocol," Lawson explains. "But we had to have that home pump study up and running because that's the base of this." Automated insulin delivery systems are the next phase of inpatient diabetes care, and the study's success with home pumps is a crucial first step.

The goal is to have a protocol that allows automated insulin delivery to be active in the hospital for patients who meet the criteria. “As far as we know, this will be the first protocol of its kind to be trialed and eventually seek approval from national regulatory groups,” Lawson adds. This groundbreaking initiative holds the promise of revolutionizing diabetes management for hospitalized children.

(Published November 2024)

Pediatric Subspecialty News and Innovation

Our experts are redefining pediatric care. Showcasing their impact is simple. Discover the leaders behind our programs, the innovations they're driving, and the research shaping tomorrow’s care.

View All Subspecialty News