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Summer is when pump wearers need to plan ahead and take special precautions. Sun, sand, heat and water are just a few of the hazards that come with the job of summer fun that can impair your pump's performance. If you spend a significant amount of time outdoors, here are a few tips on how to make your pump time worry-free. Have a sensational summer!
Heat and Sun
Insulin stored in your pump may lose its potency much faster in the sizzling heat. Watch your blood glucose levels closely. If your glucose levels begin rising, first check the obvious. For example, when did you last change your infusion set? If this or other causes are not responsible, a loss of insulin potency may be the culprit. Exposure to intense heat may also be responsible for tubing occlusions. Always keep your pump out of direct sunlight. You can either wrap it in a towel or, better yet, place it in a cooler with an icepack.
You should also be aware that as your body attempts to cool itself, insulin circulates more quickly in the blood and is thus absorbed by tissues more rapidly. This can make you more vulnerable to hypoglycemia. Consequently, when you venture out into the heat, always carry along some fast-acting carbohydrates - those that melt in your mouth, not in the sun.
Wet and Wise
If you take a few simple precautions, you can take your pump with you in the water. MiniMed users need to use the Sportsguard accessory case, which is a waterproof casing that protects the pump from water, salt and sand, while also making it buoyant. Disetronic pumps can be made waterproof by plugging the insulin chamber vents with the tappets that come with the device (always carry a few spares).
Although these measures will make your pump waterproof, you should not take your pump diving. The waterproofing will not be effective below depths of nine feet. So if you plan on going deeper, it's best to disconnect and leave your pump behind.
You should always make sure your pump is securely fastened to your person when entering the water (a fanny pack is a good idea). Your next dive shouldn't be to search for a dislodged pump. Infusion sets should also be specially secured for the water. Wearing loose-fitting clothing while submerged in water may decrease tape adhesiveness, allowing infusion sets to work their way out. Placing the infusion set under an elastic bathing suit will help to hold the set snugly to your skin (for more information see "Swimming on the Pump," D.I. April 1998, p. 35).
Sweat can cause similar adhesion problems. When preparing your site, use alcohol wipes to strip body oil. Products such as Bard Adhesive Barrier or Skin Prep are helpful. Apply the solution to the entire insertion site area and let it dry. Once your infusion set is in place, wipe the solution around it. Quickly place adhesive dressing (Polyskin, IV 3000 or Tegaderm) over the infusion set, being sure to cover the moist adhesive solution. This will help bond your skin with the adhesive dressing. You can also try applying antiperspirant around the insertion site area. Once dry, insert the set and secure. This may help prevent moisture and increase adhesion of your set. Try Unisolve to remove tapes without removing hair or skin.
Many pump users choose to disconnect prior to water or sporting activities, especially when the activity will last an hour or less. This allows you to leave your pump in a dry, cool place, protected from water and heat.
However, when boating, consider taking your pump with you rather than leaving it behind. Unless it is a very short swim to shore, you'd hate not to have your pump should your boat run out of gas or, if sailing, lose wind in the doldrums.
If you use Humalog in your pump, the duration of this insulin is much shorter than that of Regular, so it's a good idea to check your glucose levels within an hour or so after disconnecting. It may be necessary to reconnect periodically and bolus the missed basal insulin. When and how much insulin to bolus to make up for missed basal insulin depends on your initial glucose levels, activity levels and your degree of sensitivity to insulin.
For occasional short sporting events, it may be easiest to add additional food without adding insulin to prevent lows from occurring. If you exercise regularly or for long periods, it may take some experimentation before precisely determining your exact insulin needs. When recovering from long periods of exercise, some Humalog users take Regular insulin (via syringe) to recover the lost basal insulin.
Finally, be wary of alcohol consumption. Alcohol will increase your risk of hypoglycemia. Some people initially experience hyperglycemia after consuming alcohol, followed by lows several hours later. This type of reaction may be caused by mixers, shots of hard liquor or sweet wine.
Drink plenty of water before, during and after alcohol consumption. Don't drink on an empty stomach and avoid excessively sweet mixers. If your choices are limited, choose a light beer, dry wine or alcohol mixed with tomato juice or diet cola, which are less likely to cause changes in blood glucose levels. Monitoring blood glucose levels frequently will help you learn to make proper choices when it comes to alcohol consumption.
Diabetes Health is the essential resource for people living with diabetes- both newly diagnosed and experienced as well as the professionals who care for them. We provide balanced expert news and information on living healthfully with diabetes. Each issue includes cutting-edge editorial coverage of new products, research, treatment options, and meaningful lifestyle issues.