I am on an insulin pump, and I will be going to Jamaica where I plan on scuba diving and participating in water sports. I checked on the sports guard, but it is not recommended to have the pump on for depths exceeding eight feet. Will ocean water affect my site when I disconnect (tape loosen, infection from ocean water on site)? Should I disconnect for the days I plan on participating in water sports and use syringes for insulin?

Talk with your healthcare provider for your particular needs. With his/her help, you can make decisions on whether to wear the insulin pump and disconnect for water sports vs. taking insulin by syringe depending on how long you will be in the water.

If you are in for an hour or two, you can test blood glucose, disconnect the pump, be off one to two hours and then test blood glucose and reconnect, giving a correction bolus if necessary. If you are in the water all day you could check blood glucose, if appropriate, give insulin you would be missing the first hour by basal then disconnect and re-connect to bolus for meals being sure to give correction bolus at meals if blood glucose high. You could also take long acting and short acting insulin and go off the pump for the day.

It is a very individualized decision depending on your activity level, your total daily insulin and how long you would need to disconnect from the pump. The main thing to consider is that when on pump therapy there is not long acting insulin and any short acting insulin is gone in just a couple of hours, increasing the risk of DKA [diabetic ketoacidosis] due to absence of insulin.

MG