Inpatient Use of Automated Insulin Delivery Systems

Automated insulin delivery (AID) systems have improved outpatient glycemic control, reduced hypoglycemia, and enhanced quality of life for many people with diabetes. Interest is growing in translating these systems to inpatient care, where conventional insulin regimens are frequently associated with glycemic excursions and highly variable insulin requirements.

We conducted a narrative review of peer-reviewed studies evaluating inpatient use of AID systems, including both hospital-initiated AID and continuation of personal outpatient AID devices during hospitalization, across medical and surgical populations.

As outpatient adoption of AID systems increases, hospital clinicians are encountering patients using these technologies more frequently during admission. Available studies of both hospital-initiated AID and continued personal AID use during hospitalization suggest feasibility and safety, with improvements in time in range and no clear increase in hypoglycemia, although large-scale data remain limited. Broader implementation is constrained by important operational and regulatory barriers, including limited electronic health record integration, lack of device interoperability, regulatory clearance, and the absence of standardized institutional policies.

As inpatient exposure to AID systems continues to expand, hospitals must develop infrastructure and operational policies to support safe use of personal devices and to evaluate hospital-initiated AID for patients with difficult-to-manage hyperglycemia. This review summarizes current evidence and highlights key challenges to integrating AID systems into routine inpatient diabetes care.