Purpose of Review
Summarize safety issues related to patients using insulin pump therapy and continuous glucose monitoring systems (CGMS) in the outpatient setting when they are hospitalized and to review steps that can be taken to mitigate risk associated with use or discontinuation of these devices.
Two recent consensus conferences were held on the topics of inpatient use of insulin pumps and CGMS devices. In addition to commonly known safety issues (e.g., device malfunction, infection), cybersecurity and the vulnerability of contemporary technology to hacking have emerged. CGMS capabilities offer the promise of advancing the goal for development of glucometry (centralized monitoring of real-time glucose data). Strategies to assuring safe use of insulin pumps and CGMS in the hospital include collaboration between the patient and staff, proper patient selection, and clear policies and procedures outlining safe use. Available data indicates few adverse events associated with these devices in the hospital.
Current data suggests, with proper patient selection and a clear process in place for glycemic management, that adverse events are rare, and consensus favors allowing use of the technology in the hospital. The topic of insulin pump and CGMS in the hospital would greatly benefit from more institutions reporting on their experiences and prospective clinical trials.
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Continuous glucose monitoring systems
Continuous subcutaneous insulin infusion
Papers of particular interest, published recently, have been highlighted as: •• Of major Importance
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Conflict of Interest
Bithika Thompson, Melinda Leighton, and Curtiss B. Cook declare that they have no conflict of interest.
Mary Korytkowski reports the following disclosures: other from Novo Nordisk, other from Department of Defense, other from Jaeb Center for Health Research and Leona Helmsley Foundation, other from American Diabetes Association and Vietnam Diabetes/Endocrine Association, other from American Board of Internal Medicine: Endocrinology and Metabolism Exam Committee.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
This article is part of the Topical Collection on Hospital Management of Diabetes.
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Thompson, B., Leighton, M., Korytkowski, M. et al. An Overview of Safety Issues on Use of Insulin Pumps and Continuous Glucose Monitoring Systems in the Hospital. Curr Diab Rep 18, 81 (2018). https://doi.org/10.1007/s11892-018-1056-7
- Continuous subcutaneous insulin infusion
- Continuous glucose monitoring systems
- Insulin pump
- Diabetes mellitus