{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T22:02:10Z","timestamp":1791669730343,"version":"4.3.4"},"reference-count":20,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Pediatric data on inpatient home insulin pumps are absent in the literature. Understanding safety of home insulin pumps, managed by patients or caregivers, during times of illness will help diabetes technology securely move into pediatric hospitals.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine whether insulin can be safely and accurately delivered to hospitalized children through home insulin pumps when managed by patients or caregivers.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This single-center, retrospective, observational cohort study included children with insulin-dependent diabetes admitted to a tertiary children\u2019s hospital from January 1, 2016, to December 31, 2021. In all these patients, diabetes was the primary or secondary diagnosis on admission.<\/jats:p><\/jats:sec>Exposure<\/jats:title>Insulin delivery via home insulin pump, hospital insulin pump, or subcutaneous injection.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Hyperglycemia (glucose, &amp;gt;250 mg\/dL) and hypoglycemia (glucose, &amp;lt;45 mg\/dL) rates (quantified as the proportion of total insulin-days), glucose variability, and diabetic ketoacidosis (DKA) recurrences were compared for hospital pumps (manual mode), home pumps (manual mode), and subcutaneous injections using bivariate tests.<\/jats:p><\/jats:sec>Results<\/jats:title>There were 18\u202f096 insulin-days among 2738 patients aged 0.5 to 25 years (median age, 15.8 years [IQR, 12.3-18.3 years]). Overall, 990 (5.5%) of insulin-days involved hospital insulin pumps, and 775 (4.3%) involved home pumps. A total of 155 insulin-days (15.7%) involving hospital pumps were hyperglycemic, compared with 209 (27.0%) involving home pumps and 7374 (45.2%) involving injections (P<\/jats:italic>\u2009&amp;lt;\u2009.001). Moderate hypoglycemia days comprised 31 insulin-days (3.1%) involving hospital pumps compared with 35 (4.5%) involving home pumps and 830 (5.1%) involving injections (P<\/jats:italic>\u2009=\u2009.02). Severe hypoglycemia did not differ significantly according to insulin delivery method. Two patients using injections (0.01%) developed DKA; no patients using hospital or home pumps developed DKA.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study, home insulin pump use was found to be safe in a children\u2019s hospital regarding hyperglycemia and hypoglycemia. These data support use of home insulin pumps during pediatric admissions in patients who do not require intensive care and without active DKA.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.54595","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T16:03:17Z","timestamp":1707321797000},"page":"e2354595","source":"Crossref","is-referenced-by-count":4,"title":["Home Insulin Pump Use in Hospitalized Children With Type 1 Diabetes"],"prefix":"10.1001","volume":"7","author":[{"given":"Jodi","family":"Owens","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Courter","sequence":"additional","affiliation":[{"name":"Division of Pharmacy, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine L.","family":"Schuler","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio"},{"name":"University of Cincinnati College of Medicine, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Lawrence","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Hornung","sequence":"additional","affiliation":[{"name":"Division of Biostatistics & Epidemiology, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Lawson","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio"},{"name":"University of 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