Survey of Diabetes Technology in the Pediatric Inpatient Setting

Advances in diabetes technology have led to increasing use of insulin pumps and continuous glucose monitors (CGMs) to improve the quality of life for children with diabetes. The objective of this study was to assess the percentage of hospitals that had policies regarding the use of diabetes technology in the pediatric inpatient setting and assess the content of policies to identify specific areas for improvement.

A diabetes technology survey was developed by a multidisciplinary research team, consisting of 3 domains including CGM use/policies, insulin pump use/policies, and demographics. It was distributed to the pharmacist membership of the Pediatric Pharmacy Association in August 2022. Descriptive statistics were conducted to describe current practices/policies.

Seventeen of the 31 responding hospitals (55%) allowed CGM use in the pediatric inpatient setting with 77% (n = 13) having written policies. Primary barriers to use included lack of policy (n = 11, 79%), knowledgeable staff (n = 10, 71%), and electronic health record (EHR) integration (n = 6, 43%). More than half reported not using CGM alarms for high and low blood sugar levels (n = 10, 59%). More hospitals allowed insulin pump use (n = 29, 94%) with 97% (n = 28) reporting written policies. Less than half had specific policies for suspected pump site failure (n = 13, 46%). Only 60% reported that nurses verify insulin pump doses given.

This study demonstrates there is room to improve both the existence and content of policies related to CGM and insulin pump use in hospitals.