---
title: "Insulin Pump Therapy Linked to Lower 30-Day Readmission and In-Hospital Mortality in Adults with T"
id: "pubmed-42530032"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42530032"
content_type: "clinical_feed_article"
specialty: "Endocrinology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42530032/"
doi: "10.1210/clinem/dgag307"
published_at: "2026-10-16T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Insulin Pump Therapy Linked to Lower 30-Day Readmission and In-Hospital Mortality in Adults with T
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42530032
- **Specialty:** [Endocrinology](https://medichelpline.com/clinical-feed/endocrinology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42530032/)
- **DOI:** [10.1210/clinem/dgag307](https://doi.org/10.1210%2Fclinem%2Fdgag307)
- **Published At:** 2026-10-16T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Retrospective analysis used the 2022 Nationwide Readmissions Database to evaluate adults (≥18 years) hospitalized with **type 1 diabetes** identified by ICD-10-CM codes. The study defined index admissions as the first eligible hospitalization in the calendar year and excluded December and elective admissions to allow complete 30-day follow-up. - Exposure compared **insulin pump therapy** (with or without injectable insulin) versus injectable insulin only. Time to first all-cause readmission within 30 days was the primary outcome. Secondary outcomes included in-hospital mortality during index admission and during readmission. - The weighted cohort comprised 230,958 adult index admissions. Thirty-day readmission occurred in 14.64% of pump users versus 20.63% of injectable-only users. After multivariable adjustment, pump therapy was associated with reduced readmission risk (adjusted hazard ratio [aHR], 0.77; 95% CI, 0.74–0.81; P < .001). - In secondary analyses the reduced readmission association persisted for 90-day outcomes. In-hospital mortality during the index admission was 0.90% (95% CI, 0.78–1.05) for pump users and 1.31% (95% CI, 1.21–1.42) for injectable-only users. Pump therapy remained associated with lower mortality (adjusted odds ratio [aOR], 0.78; 95% CI, 0.66–0.93; P = .006). - Investigators used survey-weighted Cox and logistic regression models to estimate adjusted hazard ratios and odds ratios. The source did not report medication dosing regimens, pump models, or duration of pump use prior to admission. - The analysis is nationally representative and all-payer; however, it is observational and relies on administrative coding. The paper did not detail granular clinical variables such as outpatient glycemic control metrics or reasons for readmission beyond all-cause classification.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Department of Internal Medicine, Wayne State University and Trinity Health Oakland Hospital, Pontiac, MI 48341, USA. * 2 Department of Biomedical Sciences, Wayne State University School of Medicine, Detroit, MI 48203, USA. * 3 Department of Endocrinology, Trinity Health Livonia, Livonia, MI 48152, USA. * 4 Department of Endocrinology, Trinity Health Endocrinology, Rochester Hills, MI 48309, USA. * 5 Department of Endocrinology, Wayne State University, Detroit, MI 48201, USA. * PMID: **42530032** * DOI: [ 10.1210/clinem/dgag307 ](https://doi.org/10.1210/clinem/dgag307) Item in Clipboard # Insulin pump use and hospital outcomes in adults with type 1 diabetes: a 2022 Nationwide Readmissions Database analysis Reshma Reguram et al. J Clin Endocrinol Metab. 2026. Show details Display options Display options Format Abstract PubMed PMID J Clin Endocrinol Metab Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Clin+Endocrinol+Metab%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Clin+Endocrinol+Metab%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42530032/) . 2026 Oct 16;111(11):3269-3276. doi: 10.1210/clinem/dgag307. ### Authors [Reshma Reguram](https://pubmed.ncbi.nlm.nih.gov/?term=Reguram+R&cauthor_id=42530032)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42530032/#short-view-affiliation-1 "Department of Internal Medicine, Wayne State University and Trinity Health Oakland Hospital, Pontiac, MI 48341, USA."), [Rushi Shah](https://pubmed.ncbi.nlm.nih.gov/?term=Shah+R&cauthor_id=42530032)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42530032/#short-view-affiliation-1 "Department of Internal Medicine, Wayne State University and Trinity Health Oakland Hospital, Pontiac, MI 48341, USA."), [Tanisha Vora](https://pubmed.ncbi.nlm.nih.gov/?term=Vora+T&cauthor_id=42530032)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42530032/#short-view-affiliation-1 "Department of Internal Medicine, Wayne State University and Trinity Health Oakland Hospital, Pontiac, MI 48341, USA."), [Camelia Arsene](https://pubmed.ncbi.nlm.nih.gov/?term=Arsene+C&cauthor_id=42530032)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42530032/#short-view-affiliation-1 "Department of Internal Medicine, Wayne State University and Trinity Health Oakland Hospital, Pontiac, MI 48341, USA."), [Geetha Krishnamoorthy](https://pubmed.ncbi.nlm.nih.gov/?term=Krishnamoorthy+G&cauthor_id=42530032)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42530032/#short-view-affiliation-1 "Department of Internal Medicine, Wayne State University and Trinity Health Oakland Hospital, Pontiac, MI 48341, USA."), [Sudhanva Neti](https://pubmed.ncbi.nlm.nih.gov/?term=Neti+S&cauthor_id=42530032)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42530032/#short-view-affiliation-2 "Department of Biomedical Sciences, Wayne State University School of Medicine, Detroit, MI 48203, USA."), [Durga Yerasuri](https://pubmed.ncbi.nlm.nih.gov/?term=Yerasuri+D&cauthor_id=42530032)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42530032/#short-view-affiliation-3 "Department of Endocrinology, Trinity Health Livonia, Livonia, MI 48152, USA."), [F N U Manas](https://pubmed.ncbi.nlm.nih.gov/?term=Manas+FNU&cauthor_id=42530032)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42530032/#short-view-affiliation-4 "Department of Endocrinology, Trinity Health Endocrinology, Rochester Hills, MI 48309, USA."), [Wael Taha](https://pubmed.ncbi.nlm.nih.gov/?term=Taha+W&cauthor_id=42530032)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42530032/#short-view-affiliation-5 "Department of Endocrinology, Wayne State University, Detroit, MI 48201, USA.") ### Affiliations * 1 Department of Internal Medicine, Wayne State University and Trinity Health Oakland Hospital, Pontiac, MI 48341, USA. * 2 Department of Biomedical Sciences, Wayne State University School of Medicine, Detroit, MI 48203, USA. * 3 Department of Endocrinology, Trinity Health Livonia, Livonia, MI 48152, USA. * 4 Department of Endocrinology, Trinity Health Endocrinology, Rochester Hills, MI 48309, USA. * 5 Department of Endocrinology, Wayne State University, Detroit, MI 48201, USA. * PMID: **42530032** * DOI: [ 10.1210/clinem/dgag307 ](https://doi.org/10.1210/clinem/dgag307) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract **Context:** Adults with type 1 diabetes (T1D) experience substantial inpatient morbidity, including frequent readmissions and measurable in-hospital mortality, contributing significantly to US health care utilization. **Objective:** To evaluate the association between insulin delivery modality and 30-day readmission and in-hospital mortality among adults hospitalized with T1D. **Design, setting, and participants:** Retrospective cohort study using the 2022 Nationwide Readmissions Database, a nationally representative all-payer inpatient database. Adults (≥18 years) hospitalized with T1D were identified using ICD-10-CM codes. Index admissions were defined as the first eligible hospitalization per patient within the calendar year; December and elective admissions were excluded to ensure complete 30-day follow-up. **Exposure:** Insulin pump therapy (± injectable insulin) vs injectable insulin only. **Main outcomes and measures:** Primary outcome was time to first all-cause readmission within 30 days. Secondary outcomes included in-hospital mortality during index admission and readmission. Survey-weighted Cox and logistic regression models estimated adjusted hazard ratios (aHRs) and odds ratios (aORs). **Results:** The weighted cohort included 230 958 adult index admissions. Thirty-day readmission occurred in 14.64% of pump users vs 20.63% of injectable-only users. After multivariable adjustment, pump therapy was associated with lower readmission risk (aHR, 0.77; 95% CI, 0.74-0.81; P < .001). In secondary analyses, this association persisted for 90-day readmission outcomes. In-hospital mortality during index admission was lower among pump users (0.90% [95% CI, 0.78-1.05]) compared with injectable-only users (1.31% [95% CI, 1.21-1.42]). Pump therapy remained associated with reduced mortality (aOR, 0.78; 95% CI, 0.66-0.93; P = .006). **Conclusion:** In this nationally representative cohort, insulin pump therapy was independently associated with lower 30-day readmission and in-hospital mortality among adults with T1D. **Keywords:** 30-day readmission; diabetes technology; health care utilization; in-hospital mortality; insulin pump therapy; type 1 diabetes mellitus. © The Author(s) 2026. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. 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