Insulin Pump Associated With Decreased Incidence of Diabetic Ketoacidosis in Youth With Type 1 Diabetes

insulin pump system
insulin pump system
Investigators assessed the prevalence of diabetic complications among youth with type 1 diabetes with or without use of insulin pumps.

For hospitalized youth with type 1 diabetes (T1D), those who used an insulin pump were found to experience lower rates of diabetic ketoacidosis (DKA) compared with nonusers of an insulin pump, according to results of a study published in The Journal of Clinical Endocrinology & Metabolism.

Data were sourced from the Healthcare Cost and Utilization Project Kids’ Inpatient Database, which contains hospital admission data for youth aged 20 years and younger at 42,000 hospitals in 46 states. Admissions in 2006, 2009, 2012, and 2016 were assessed for trends in insulin pump use and DKA.

A total of 228,474 hospitalizations were recorded for youth with T1D; among these patients, 55.1% were female, 51.1% were White, and 81.1% lived in urban areas. Insulin pump use was documented in 7% of the hospitalizations, and 3179 patients had documented pump failure. Users and nonusers differed significantly for all demographic data (all P £.011). From 2006 to 2016, insulin pump use increased by 10% (P <.001).

Nearly half of all patients (48.14%) had DKA during hospitalization and most (~85%) had minor or moderate severity of illness. Fewer pump users had documented DKA (39.29% vs 46.50%; P <.001), but the rate of DKA was higher among patients with pump failure (60.33%).

The length of hospital stay was longest for pump nonusers (mean, 2.89 days), followed by pump users (mean, 2.24 days) and patients with pump failure (mean, 1.60 days). Similarly, hospital charges were highest for nonusers (mean, $20,486), followed by pump users (mean, $17,672) and those with pump failure (mean, $13,078).

This study found that there were few documented instances of insulin pump use; however, the study authors noted that this low rate may have been a byproduct of undercoding.

In summary, the researchers found that patients with T1D who used an insulin pump experienced decreased rates of DKA and shorter hospital stays, and incurred lower hospital charges. However, it appears that a minority of youth with T1D use insulin pumps.


Everett EM, Copeland TP, Moin T, Wisk LE. Insulin pump–related inpatient admissions in a national sample of youth with type 1 diabetes. J Clin Endocrinol Metab. Published online February 23, 2022. doi:10.1210/clinem/dgac047