{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:45:21Z","timestamp":1792053921826,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We compared characteristics of adults with insulin\u2010treated diabetes using continuous subcutaneous insulin infusion (CSII) versus multiple daily insulin injections (MDI) during admission with acute coronary syndrome (ACS) and identified factors associated with in\u2010hospital mortality among CSII users.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study used the Myocardial Ischaemia National Audit Project, a registry of ACS admissions in England and Wales. Adults aged \u226518\u2009years with confirmed ACS and insulin\u2010treated diabetes were classified as CSII or MDI users. Baseline characteristics were compared. Gradient boosting machine (GBM) modelling and multivariable logistic regression evaluated mortality predictors among CSII users.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cohort included 3321 CSII users and 30,593 MDI users. In\u2010hospital mortality was higher among CSII users (11.4% vs. 5.1%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). CSII users had higher rates of cardiogenic shock (4.8% vs. 1.3%), pulmonary oedema (12.1% vs. 8.3%), poor left ventricular systolic function (23.5% vs. 19.7%), and STEMI (32.2% vs. 20.5%). Cardiogenic shock was the strongest predictor of mortality (adjusted OR 10.46, 95% CI 6.95\u201315.81), followed by poor left ventricular function (OR 4.15, 95% CI 2.69\u20136.53), basal crepitations (OR 1.94, 95% CI 1.40\u20132.67) and pulmonary oedema (OR 1.56, 95% CI 1.05\u20132.28). Higher systolic blood pressure was associated with lower mortality (OR 0.86 per 10\u2009mmHg, 95% CI 0.82\u20130.90). The GBM model achieved an AUC of 0.85 and a Brier score of 0.088.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CSII users admitted with ACS represented a more complex group with haemodynamic compromise and higher unadjusted mortality. Findings predominantly reflect the open\u2010loop CSII era and may not generalise to contemporary hybrid closed\u2010loop systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70401","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T04:49:48Z","timestamp":1783054188000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics and in\u2010hospital mortality among insulin pump users with acute coronary syndrome in the predominantly open\u2010loop era: A\n                    <scp>UK<\/scp>\n                    \u2010wide\n                    <scp>MINAP<\/scp>\n                    registry analysis"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3859-3118","authenticated-orcid":false,"given":"Harshal","family":"Deshmukh","sequence":"first","affiliation":[{"name":"James Cook University  Townsville City Queensland Australia"},{"name":"Gold Coast University Hospital  Gold\u00a0Coast Queensland Australia"},{"name":"Allam Diabetes Center Hull University Teaching Hospital NHS Trust  Hull UK"},{"name":"University of Hull  Hull UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moosa","family":"Shaikh","sequence":"additional","affiliation":[{"name":"Allam Diabetes Center Hull University Teaching Hospital NHS Trust  Hull UK"},{"name":"University of Hull  Hull UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8698-6207","authenticated-orcid":false,"given":"Emma G.","family":"Wilmot","sequence":"additional","affiliation":[{"name":"Translational Medical Sciences University of Nottingham  Nottingham UK"},{"name":"Diabetes Department University Hospitals of Derby and Burton NHS FT  Derby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Kilpatrick","sequence":"additional","affiliation":[{"name":"University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6421-6762","authenticated-orcid":false,"given":"Sudipta","family":"Chattopadhyay","sequence":"additional","affiliation":[{"name":"Bedfordshire Hospitals NHS Foundation Trust  Bedford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3544-2231","authenticated-orcid":false,"given":"Thozhukat","family":"Sathyapalan","sequence":"additional","affiliation":[{"name":"Allam Diabetes Center Hull University Teaching Hospital NHS Trust  Hull UK"},{"name":"University of Hull  Hull UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"John","sequence":"additional","affiliation":[{"name":"Allam Diabetes Center Hull University Teaching Hospital NHS Trust  Hull 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