Redefining Inpatient Diabetes Care: A Policy-Driven Approach to Safe and Effective Technology Use

Advanced diabetes self-management technology, such as integrated insulin pumps with continuous glucose monitors (CGM), has become increasingly popular among patients with diabetes. However, concerns surrounding their use in the inpatient setting, including safety risks and provider and nursing comfort, have raised questions about their effectiveness. A recent study published in the Journal of the American Association of Nurse Practitioners investigated the implementation of a policy-driven approach to safe and effective technology use in inpatient diabetes care.

Key Takeaways:

• The study was conducted at a 332-bed hospital in the Southeastern United States, where the inpatient insulin pump policy did not support current evidence-based clinical recommendations.
• An updated policy was designed to allow patients to continue using automated insulin pumps during hospitalization, with nursing education provided on the new policy release.
• The updated policy was applied to all patients admitted using automated insulin pumps over 19 weeks, resulting in improved glucose control, patient satisfaction, and nursing comfort levels.
• Mean glucose levels were significantly lower (153.6 mg/dl) when patients used automated insulin pumps with CGM compared to stand-alone insulin pumps (201.4 mg/dl) and subcutaneous insulin injections (262.3 mg/dl).
• Time in range (TIR) was achieved at 72.1% for patients using automated insulin pumps, compared to 44.3% for those using insulin pumps without CGM and 31.7% for those using subcutaneous insulin injections.
• The study concluded that applying an evidence-based policy that allows patients to remain on their automated insulin pump during hospitalization maintains glycemic control and patient satisfaction, as well as improves nursing comfort levels.

Statistics:

• Mean glucose levels: 153.6 mg/dl (automated insulin pump), 201.4 mg/dl (standalone insulin pump), and 262.3 mg/dl (subcutaneous insulin injections)
• Time in range (TIR): 72.1% (automated insulin pump), 44.3% (insulin pump without CGM), and 31.7% (subcutaneous insulin injections)
• 19 weeks: duration of the study
• 5 of 9 realms on the postnursing survey showed significant improvement (p-value not specified)

Sources:

• Redefining inpatient diabetes care: A policy-driven approach to safe and effective technology use. Journal of the American Association of Nurse Practitioners, 2025.
• Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA.