Perioperative Insulin Pump Therapy Decreases Readmission Risk and
                    Improves Outcomes in Patients with Diabetes

Kun Wang; Fang Bai; Xiaopan Chen; Joshua D. Miller; Xue Chen; Chuan Yun; Zhenzhen Sun; Xiaodan Yuan; Qingqing Lou

doi:10.1055/a-2218-4574

Experimental and Clinical Endocrinology & Diabetes, Inhaltsverzeichnis

Exp Clin Endocrinol Diabetes 2024; 132(03): 142-151
DOI: 10.1055/a-2218-4574

Article

Perioperative Insulin Pump Therapy Decreases Readmission Risk and Improves Outcomes in Patients with Diabetes

Authors

Kun Wang^†

¹The First Affiliated Hospital of Hainan Medical University, Hainan Clinical Research Center for Metabolic Disease, Haikou, Hainan, China

²Nursing College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
Fang Bai^†

¹The First Affiliated Hospital of Hainan Medical University, Hainan Clinical Research Center for Metabolic Disease, Haikou, Hainan, China
Xiaopan Chen

¹The First Affiliated Hospital of Hainan Medical University, Hainan Clinical Research Center for Metabolic Disease, Haikou, Hainan, China
Joshua D. Miller

³Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
Xue Chen

⁴Jiangsu College of Nursing, Huaian, Jiangsu, China
Chuan Yun

¹The First Affiliated Hospital of Hainan Medical University, Hainan Clinical Research Center for Metabolic Disease, Haikou, Hainan, China
Zhenzhen Sun

²Nursing College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
Xiaodan Yuan

⁵Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
Qingqing Lou

¹The First Affiliated Hospital of Hainan Medical University, Hainan Clinical Research Center for Metabolic Disease, Haikou, Hainan, China

Abstract

Objective To evaluate the impact of temporary insulin pump use during hospitalization on glycemia, postoperative complications, and cost/utilization in perioperative patients with diabetes.

Methods Patients (n=159) with type 2 diabetes and hospitalized for elective surgery were recruited from three hospitals. Subjects were categorized into the insulin pump group and the multiple daily subcutaneous insulin injection group according to their treatment therapy. Data were collected at admission, discharge, and 3 months post-discharge.

Results Subjects in the CSII group who were still on insulin therapy transitioned from CSII to MDII; however, their daily insulin dosages were lower than those in the MDII group (15.31±10.98 U/d vs. 23.48±17.02 U/d, P=0.015) after discharge. In terms of medical costs, the CSII group had significantly higher hospitalization costs than the MDII group (112.36±103.43 thousand RMB vs. 82.65±77.98 thousand RMB, P=0.043). After 3 months, the CSII group had significantly lower outpatient costs than the MDII group (3.17±0.94 thousand RMB vs. 3.98±1.76 thousand RMB, P ˂ 0.001). In the MDII group, 10 patients reported severe postoperative complications requiring re-hospitalization; there were no similar reports in the CSII group.

Conclusion Temporary use of insulin pump therapy for perioperative patients with diabetes results in a reduction in blood glucose and blood glucose fluctuation during hospitalization, HbA1c, and the risk of postoperative complication and readmission, thus significantly decreasing costs in this complex patient cohort. Further work is needed to better understand indications for utilizing pump therapy based on diabetes phenotype and the complexity of planned surgical intervention.

Key words

insulin pump - multiple daily subcutaneous insulin injection - perioperative insulin pump therapy

Volltext

Referenzen

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