Site Selection Care And Rotation
Different areas of the body generally absorb the rapid-acting insulin analogs used in pumps at similar rates. However, people may find slight variations from one body area to another and should keep this in mind if they notice otherwise unexplained fluctuations in their blood glucose levels after changing infusion areas.
The most comfortable place to insert an infusion set for most pump users is the abdominal area, which also has the most consistent absorption rate. During pregnancy it is still appropriate to insert in the abdomen as long as the subcutaneous tissue can be pinched up.
Other infusion sites include the outer thighs, backs of the arms, hips, and buttocks. The thighs and arms usually have slower absorption rates than the abdominal area, but the rates may accelerate with increased activity. The backs of the arms can be a difficult to use if dexterity is an issue. Many people choose the hips and buttocks as their infusion sites since these areas tend to have more subcutaneous fat and may be more comfortable, especially for people who are very active or dont have much body fat in general.
When selecting an infusion site, avoid bony areas and places where the infusion set might be constricted, such as areas that will be covered with tight-fitting clothing. Also avoid areas that contain scar tissue, superficial blood vessels, body piercings, or tattoos. It is also important to stay two inches away from the navel.
Always Be Prepared For Low Blood Sugar
Being prepared for low blood sugar while swimming or relaxing in a hot tub is as crucial as being prepared during any other type of exercise. Here are a few things to keep in mind when deciding what types of fast-acting carbohydrates to carry with you:
- Something that will not melt or rot in the heat .
- Something that can treat multiple low blood sugars .
- Something that can be stored in a waterproof container if, for example, youre taking it with you in a kayak or canoe.
- Ideal sources include glucose tabs or gel, gummy candies, jelly beans, Pixie Stix, etc.
Also remember to inform everyone youre swimming with about your diabetes. If youre frolicking in ocean waves and distracted by the fun, it could be easy to overlook symptoms of hypoglycemia. Let your friends be part of your team and ask for help if you need it.
Backup Plan Is A Must When Swimming With An Insulin Pump
Make sure you have a backup plan in case the battery dies or the device malfunctions. Having a swimming partner is always a good idea, but if youre swimming solo then make sure to have an alternate plan in case of emergency.
But in all cases, always tell the on-duty lifeguard about your insulin pump and ask them if they could watch out for you.
Carry a spare set of batteries with you at all times, just in case. Even though if your insulin pump is waterproof or water-resistant, but thats not 100% guarantee. The electrical circuit board might be proofed from water, but the battery is not. Some water might get inside or in some cases, some water vapour might get inside and damage your battery. So, its always a good idea to have spare batteries.
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And When The Seasons Change Here Are A Few Things To Remember:
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Plan ahead before you enter new environments, from x-rays to airport security, so you know how they could affect your pump.
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For those of you on the MiniMed 670G or 640G systems, its good to note at the time of manufacture and when reservoir and tubing are inserted properly, your pump is waterproof to a depth of up to 12 feet for up to 24 hours. See user guide for details. Be aware that drops and bumps that occur over time will affect the integrity of the pump and make it more vulnerable to damage from water.
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MiniMed 670G and 640G systems are water-resistant, so disconnect from your pump when showering, swimming, or using the sauna or steam room. Place it in a safe and dry place, away from moisture.
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When your transmitter is connected to your sensor, they create a watertight seal in up to 8 feet of water for 30 minutes. If you are wearing CGM and disconnect your pump from your body your transmitter will store your data during that time. But keep in mind, if youre away for your pump for 30 minutes or more, you will get a Lost Sensor alert. Speak with your healthcare team to establish a plan if youre going to regularly disconnect from your pump for longer than one hour.
1 At the time of manufacture and when reservoir and tubing are inserted properly, your pump is waterproof to a depth of up to 12 feet for up to 24 hours. See user guide for details.
What To Do In The Event It Stops Functioning
If the pump stops functioning, you should immediately check your blood sugar and start your back up plan.
Usually a back up plan consists of giving an injection of rapid acting insulin every few hours to cover your basal and then more injections for food/correction. Some people may also have a prescription for long acting insulin on file at the pharmacy or some that is kept in the refrigerator, so you could give a shot of that and revert to multiple daily injections until your pump is replace.
Always check first to make sure your insulin is not expired. Once you know your blood sugar is fine, then contact your pump company and let them know the situation, they should overnight another pump to you. If your pump is out of warranty , then be prepared to possibly be on injections for a few days or even up to a few weeks until the certificate of medical necessity and paperwork has been gathered and submitted to the insurance company for a new pump.
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Etiology Of Dermatological Concerns
As the literature has shown, CGM and CSII device usage can lead to skin injury and irritation , scarring, and lipodystrophy. Hypersensitivity reactions are typically classified as one of four types.25 Type 1 hypersensitivity is termed immediate type hypersensitivity, is IgE mediated, and is the form most common in atopic-type skin reactions. Reactions typically occur within minutes. Type 2 hypersensitivity and type 3 hypersensitivity are not typical to diabetes device wear, and are not covered in this study. Type 4 hypersensitivity is termed delayed-type or cell-mediated hypersensitivity, and is the most common form of hypersensitivity reaction. It is T-cell mediated, and occurs in response to sensitization to the offending agent in susceptible individuals. Reactions typically take a long period of exposure to induce initially, but may occur more rapidly after repeated exposure due to reactivation of memory Th1 cells. These reactions may occur in response to chemicals in CGM and IIS adhesives.
Scarring is another dermatological complication from CGM and IIS and appears to be more common with IIS. Scarring manifests as small hypo- or hyperpigmented lesions of fibrous tissue.12,28 Although it is unclear whether scarring affects sensor accuracy or insulin absorption, it may disrupt the insertion process of sensors or cannulas, and scarred areas should therefore be avoided when selecting new insertion sites.
Is Your Blood Sugar Unexpectedly High Following Exercise
When the blood sugar is unexpectedly high after exercise, think about why. Generally, exercise will lower your blood sugar. If the post- exercise blood sugar reading is unexpectedly high, you may need to consider if your blood sugar dropped so low during the activity that your body re-regulated itself by releasing counter-regulatory hormones. If so, the subsequent rebound can cause a high blood sugar reading. Other considerations might be overestimating the impact of the exercise, engaging in a stressful kind of exercise and eating too much carbohydrate beforehand.
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Travelling With An Insulin Pump: Your One
So you’ve decided you may want to make the switch to a pump, or you already have a pump and are now deciding you want to go on holiday somewhere. So maybe you have some of the following questions …
“Do you have trouble at the airports when travelling with an insulin pump?”
“Do you ever just switch back to insulin pens?”
“Is it annoying carrying insulin pump supplies?”
The answer is…yes, no and maybe! Keep reading…
When I travel I always bring an insulin pump and insulin pens with me, and if I am on a long term trip, I will bring a spare insulin pump too. This is for many reasons, one being that I need backup insulin if my pump fails me, and another being there are actually situations in which the insulin pump just wonât cooperate with. This ranges from hot springs, to water parks to scuba diving .
I hope to one day visit Iceland and embrace the lagoons there, but when in Chile, Bradley and I ventured off into our car and came across a deserted area in the location of a volcano which not only produced breathtaking scenery, but some amazing hot springs!
Psst!! … Do you have travel insurance sorted?
Before traveling anywhere, make sure you have your travel insurance in place. We recommend SafetyWing.â
Why?
- You can pause and restart policies each month
- They are more affordable than many providers
Is My Insulin Pump Waterproof
Whether your insulin pump is waterproof or not is fully dependent on the brand. For example, my old Roche insulin pump was not waterproof, but my new Medtronic insulin pump is!
Iâve done a little research and found what each brand says:
Medtronic: The âMiniMed® Veo⢠insulin pump is splash-proof, and therefore we continue to label the MiniMed® Veo⢠as water resistant, not waterproof/watertightâ
- The Medtronic 640G is waterproof.
- The Minimed 670G waterproof for up to 24 hours at a depth of 12 feet, which is the same as the 530G.
Tandem: The t: slim is not completely waterproof. According to the company, the t: slim has been tested in three feet of water for 30 minutes, which makes it water resistant.
Roche: Accu-chek insight insulin pump is âwatertightâ, not waterproof.
âIPX8 – protected against the effects of temporary immersion in water under standardized conditions â
Accu-chek combo insulin pump is not waterproof. It needs to be removed for swimming. It can withstand brief accidental water contacts such as rain, water splashes or accidental immersion.
Ominpod: Ypsomed my life OmniPod: 7.6m depth for up to 1 hour
Just remember, that even if your insulin pump is waterproof, this will only be the case if there are no CRACKS. Itâs easy to get tiny cracks and they will no longer be waterproof. So make sure you protect your pump and check for cracks before you swim.
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What You Need To Know About Diabetes And Swimming
Swimming is great for people living with diabetes. It can reduce your risk of cardiovascular disease and help manage blood sugar levels in Type 2 and gestational diabetes. It increases insulin sensitivity and can contribute to weight loss or maintaining a healthy weight.
Having diabetes shouldnt stop you from swimming, although there are just a few things to keep in mind:
Are Insulin Pumps Dangerous
4.6/5Pumpdangerousread full answer
Medical device companies and many experts say insulin pumps are safe devices that can help diabetics lead more normal lives. They blame user error for most reported problems, noting that the pumps are complicated devices requiring special training for patients.
Secondly, what are the disadvantages of an insulin pump? The main disadvantages of pump therapy are:
- Risk of diabetic ketoacidosis from pump or site malfunction.
- Risk of skin infection.
- Cost pumps are expensive
- Need to give insulin for every carb NO free snacks.
Additionally, how long can you live with an insulin pump?
Don’t stop your pump while it is in the middle of delivering a bolus. Check your blood glucose before you disconnect. Don’t go longer than 1 to 2 hours without any insulin.
Can insulin pumps be removed?
Yes, you can suspend and disconnect your pump and tubing from your infusion site with a simple pinch and turn . However, you should never interrupt or stop the insulin delivery on your pump for more than an hour or so, unless you have a backup plan.
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Practical Comprehensive Guidance For Skin Care With Diabetes Devices
The following summary and comprehensive tables present the collective experience of our academic center’s adult and pediatric diabetes educators and endocrinologists related to use of diabetes devices. In addition to our extensive experience addressing skin integrity with CSII and CGM, recommendations from the academic literature are incorporated as well.16,18,3133 As additional perspective, contributions from the lay diabetes community have been considered, which incorporate harmoniously with existing literature and expert opinion.34,35 Recommendations requiring further research or unclear benefit have been noted.
Check Your Insulin Pump
Check to make sure your insulin pump is waterproof or water-resistant if youre planning to go swimming with insulin pump.
Some pumps are designed to be waterproof, and some have a certain level of water-resistance. The best way to know is by checking the manual that came with the device! If you dont have the manual anymore, you can always have that information on the devices website or check with your doctor.
Also, check the level of insulin inside your insulin pump. If your insulin level is more than 50%, then its good to go swimming.
If your insulin pump is water-resistant, you might want to use something like an waterproof patch or waterproof pouch, this way, you can still swim with your insulin pump.
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Pick Your Pump: What Is Most Important
All pumps basically do the same thing, they take rapid acting insulin and deliver it two ways. But when choosing an insulin pump there are many things to consider. Its important to prioritize which features are the most important to you and why. Once you have done this, it will automatically eliminate some options and make your choice much easier. Also, you dont have to go at this alone. You should discuss with your doctor and diabetes educator which pump they think would be best for you and why, that can also help to narrow it down. The main companies to choose from are: Medtronic, Tandem, Insulet, Animas, Roche and Sooil.
What experts have to say?
Why Is An Insulin Pump Good For Travelling
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What Kind Of Food Should I Take To Prevent Or Treat A Low Blood Sugar During Exercise
It may be necessary to eat a carbohydrate-containing snack to prevent a low blood sugar especially if the exercise is unplanned or prolonged. Ideally, the snack should be a liquid or readily absorbed form of simple carbohydrate. Avoid foods with complex carbohydrates because they take a longer time to digest. Avoid high fat or oily foods as they cause delayed stomach emptying and thus delay the absorption of sugar.
Access To Insulin Pumps
In Australia, insulin pump therapy is limited to people with type 1 diabetes who have private health insurance. There are some government subsidy programs and charitable organisations, such as the Juvenile Diabetes Research Foundation , that may assist with the cost of an insulin pump in special circumstances. Patients without private health insurance have to purchase the insulin pump themselves. The current commercial price of an insulin pump is approximately $10 000.
In 2017 a government subsidy for continuous glucose monitors was implemented for people under the age of 21 years. However, patients over 21 years receive no subsidy and must purchase continuous glucose monitors at the full price of approximately $300400 per month. Additional costs with pump use include consumables such as infusion sets and reservoirs, costing $2530 per month.
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