Clinical Guideline: Guidelines for managing continuous subcutaneous insulin infusion (CSII, or ‘insulin pump’) therapy in hospitalised patients

Continuous subcutaneous insulin infusion (CSII, Insulin pump) therapy is used by 10-15% of people with type 1 diabetes, and by some patients with type 2 diabetes. It is an effective option for day to day insulin delivery, but one that may not be familiar to health care professions caring for these people in an in-patient hospital setting. Therefore, patients on CSII therapy are often unnecessarily switched to alternative modes of insulin delivery on admission to hospital, or alternatively, CSII therapy maybe mismanaged. There are currently no national level guidelines for the inpatient management of CSII in the UK. These guidelines are designed to support the in-patient care of people with type 1 diabetes managed on CSII therapy. They were developed by a multi-disciplinary group of health care professionals and a patient on behalf of the Diabetes Technology Network and the Association of British Clinical Diabetologists. It has been further reviewed by national diabetes societies. It conforms to other national guidelines for diabetes / pregnancy care. It is intended that the guideline will be useful to clinicians and service commissioners in planning, organising and delivering high quality diabetes inpatient care. There remains, however, an individual responsibility of healthcare professionals to make decisions appropriate to the circumstance of the individual patient. When implementing this guideline full account should be taken of the local context and in line with statutory obligations required of the organisation and individual.