Hamilton Abby B, Rajagopal Nitya, Ngo Chloe, Hendrix-Dicken Amy D, Mercer Shelly, Condren Michelle
OU-TU School of Community Medicine (ABH, NR), Tulsa, OK.
University of Oklahoma (CN), Norman, OK.
J Pediatr Pharmacol Ther. 2025 Feb;30(1):123-128. doi: 10.5863/1551-6776-30.1.123. Epub 2025 Feb 10.
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.
糖尿病技术的进步促使胰岛素泵和持续葡萄糖监测仪(CGM)的使用日益增加,以改善糖尿病儿童的生活质量。本研究的目的是评估在儿科住院环境中制定了糖尿病技术使用政策的医院百分比,并评估政策内容以确定具体的改进领域。
一个多学科研究团队制定了一项糖尿病技术调查,包括CGM使用/政策、胰岛素泵使用/政策和人口统计学3个领域。该调查于2022年8月分发给了儿科药学协会的药剂师会员。进行描述性统计以描述当前的做法/政策。
31家回复的医院中有17家(55%)允许在儿科住院环境中使用CGM,其中77%(n = 13)有书面政策。使用的主要障碍包括缺乏政策(n = 11,79%)、知识丰富的工作人员(n = 10,71%)和电子健康记录(EHR)整合(n = 6,43%)。超过一半的医院报告未使用CGM的高血糖和低血糖警报(n = 10,59%)。更多医院允许使用胰岛素泵(n = 29,94%),其中97%(n = 28)报告有书面政策。不到一半的医院有疑似泵部位故障的具体政策(n = 13,46%)。只有60%的医院报告护士会核实胰岛素泵的给药剂量。
本研究表明,医院中与CGM和胰岛素泵使用相关的政策在存在和内容方面都有改进空间。