dromlakhani Confirm availability of insulin pump supplies for hospitalization duration
STEP 1 — Gather Information
Determine expected hospitalization duration and inventory of pump supplies (infusion sets, reservoirs, batteries, adhesives, alcohol wipes) available from patient or family.
STEP 2 — Rule In / Rule Out
Are pump supplies sufficient to cover the entire hospitalization? If YES → proceed to assess patient ability and contraindications. If NO → arrange for additional supplies or plan transition to subcutaneous insulin therapy.
STEP 3 — Classify or Stratify
Assess patient ability to self-manage pump (consciousness, dexterity, understanding) and check for contraindications (ICU stay, DKA/HHS, inability to adjust settings). If patient can safely self-manage and no contraindications → proceed to decide. If not → transition to subcutaneous insulin therapy.
STEP 4 — Decide
If supplies sufficient and patient able to self-manage with no contraindications → continue insulin pump therapy during hospitalization. Otherwise → transition to scheduled subcutaneous basal bolus insulin therapy before discontinuation of pump.
Clinical Guardrails / Mimics / Pitfalls
Do not continue pump if patient lacks ability to adjust settings, is in ICU, has DKA/HHS, or if supplies will run out; do not assume hospital will provide pump supplies; do not ignore need for basal rate adaptation at admission.
Concrete Clinical Example
A 58-year-old with type 1 diabetes on pump admitted for elective surgery expected stay 3 days. Patient brings 2 infusion sets, 3 reservoirs, batteries. Hospital has pump-expert nurse. Supplies sufficient for 3 days, patient alert and able to manage pump, no contraindications → continue pump.
Source: Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2022, https://doi.org/10.1210/clinem/dgac278