Promoting Type 1 Diabetes Self-care Management in the Hospital: Can It Be Done?

Area of Science:

• Endocrinology
• Metabolic Disorders
• Diabetes Management

Background:

• Hospitalization presents unique challenges for glycemic control in type 1 diabetes mellitus (T1DM).
• Current guidelines often involve intensified insulin management by healthcare providers during inpatient stays.
• Patient self-management of diabetes, including insulin regimens, may offer benefits but requires careful consideration.

Purpose of the Study:

• To evaluate if allowing hospitalized patients with T1DM to self-manage their insulin plan improves time in target glucose range.
• To compare glycemic outcomes and stability between self-managed and provider-managed insulin groups in hospitalized T1DM patients.

Main Methods:

• Retrospective chart review of 60 inpatients with T1DM.
• Inclusion criteria required patients to meet criteria for self-management of their diabetes care.
• Comparison between continuous subcutaneous insulin infusion (CSII) pump users and multiple daily injection (MDI) users regarding glucose outcomes and stability.

Main Results:

• Analysis of 753 glucose results across both groups.
• 37 hypoglycemic events and 311 hyperglycemic events were recorded.
• No statistically significant differences in glucose levels or stability were observed between the self-management groups (CSII vs. MDI).

Conclusions:

• No severe hypoglycemia or diabetic ketoacidosis occurred in either group.
• Diabetes self-management by select hospitalized T1DM patients may lead to comparable or improved glucose stability.
• Findings support the potential for safe and effective diabetes self-management in specific inpatient T1DM populations.