Approach to the adult hospitalized patient on an insulin pump

Abstract

Patients on continuous subcutaneous insulin infusion, or insulin pumps, are increasingly seen in hospitals. Inpatient providers need to have a working knowledge of insulin pumps to be able to decide, in conjunction with the patient whenever feasible, whether or not pump use is to be continued in the hospital, to assist patients in adjusting insulin doses via continuous subcutaneous insulin infusion, to transition patients to multiple daily subcutaneous insulin dosing as appropriate, and to prevent or manage problems that might arise from improper handling of the insulin pump. Clinical vignettes with key points and strategies for patient care are discussed in this article. Journal of Hospital Medicine 2013;8:721–727. © 2013 Society of Hospital Medicine

Peroperative Period with Diabetes Mellitus

“…Uygulanacak uzun etkili bazal insülin dozu, pompa tarafından verilen 24 saatlik bazal insülin dozuna eşdeğerdir. Bir diğer yöntemde bazal gereksinimi, bireysel insülin duyarlılığı dikkate alınarak ağırlık bazında hesaplamaktır (27) .…”

Pharmacists' role in glycemic management in the inpatient setting: An opinion of the endocrine and metabolism practice and research network of the American College of Clinical Pharmacy

“…Recommendations include implementing processes to identify appropriate candidates for inpatient CSII self‐management, developing a specific order set for in‐hospital insulin pump use, delineating patient responsibilities for self‐management, consistently documenting blood glucose (BG) measurements and insulin doses administered, and providing education to caregivers . Other recommendations include developing “menu maps” to allow for easy navigation of CSII device menus to identify settings, and posting reminders to remove CSII devices prior to tests involving electromagnetic fields . In addition, as use of continuous glucose monitors (CGMs) become more common amongst CSII device users, policies will need to include guidance on the use of CGMs in the hospital.…”

An Overview of Insulin Pumps and Glucose Sensors for the Generalist

“…Given the heterogeneity of surgical procedures and patients, there is no standardized approach to managing insulin pumps in this setting. An individualized approach should be taken [ 37 ]. When there is time for planning, as in elective procedures, tailored recommendations can be made.…”