Attitudes and Behaviors with Diabetes Technology Use in the Hospital: Multicenter Survey Study in the United States.
Nabil Z Madhun, Rodolfo J Galindo, Jessica Donato, Patricia R Hwang, Hassan F Shabir, Michael J Fowler, Ethan Molitch-Hou, James F Bena, Guillermo E Umpierrez, M Cecilia Lansang
Author Information
Nabil Z Madhun: Endocrinology and Metabolism Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Rodolfo J Galindo: Division of Endocrinology, Emory University School of Medicine, Atlanta, Georgia, USA. ORCID
Jessica Donato: Department of Hospital Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Patricia R Hwang: Division of Hospital Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Hassan F Shabir: Division of Hospital Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Michael J Fowler: Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Ethan Molitch-Hou: Section of Hospital Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, USA.
James F Bena: Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Guillermo E Umpierrez: Division of Endocrinology, Emory University School of Medicine, Atlanta, Georgia, USA.
M Cecilia Lansang: Endocrinology and Metabolism Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. ORCID
To assess the attitudes, behaviors, and barriers with diabetes technology use in the general medicine hospital wards. The authors developed a nonincentivized web-based anonymous survey that captured demographic and practice data regarding continuous subcutaneous insulin infusion (CSII) and continuous glucose monitor (CGM) use in the hospital. Four large hospital systems in the United States. Among 128 survey respondents, 76%, 10%, and 6% were hospitalists, advanced practice providers, and primary care physicians, respectively. The majority of respondents rated the treatment of inpatienthyperglycemia (96%) and the continuation of CSII during the hospital stay (93%) "important." While most respondents (64%) acknowledged knowing the existence of their institution's policies for CSII use, only 84% of those respondents felt somewhat to very familiar with the policy. The most common barrier to CSII use in the inpatient setting was lack of practitioner (70%) and nursing (67%) knowledge of using the device. With regard to CGM use in the hospital, a minority (28%) of respondents were aware of their institution's CGM policies. Less than half of the providers, 43.8%, stated that, when admitting a patient, they reviewed CGM data to guide insulin dosing. In this US multicenter survey, we found that most inpatient practitioners valued glycemic control, but many were not familiar with institutional policies, had lack of knowledge with CSII, and were not reviewing CGM data.
