August 1, 2003
Question from Aspen, Colorado, USA:
My 33 year old son, who is a professional river guide in the Grand Canyon and in Chile, developed type�1 diabetes four months ago. He currently takes Humalog and Lantus at night and would like to know if a pump will work for him since he is in and out of the water during the day, and I understand there are waterproof pumps. Sometimes he does kayak support rescue and kayaks a good deal for recreation. Will a pump be comfortable in a kayak and not come off in rolls? Are there others with this experience? Will the insulin in the pump stay cool enough in the heat of Grand Canyon (100-120 degrees)?
We have swimmers who use insulin pumps, and, as long as the period of submersion is not long, the pump can usually work. You are talking about extreme conditions. How well a pump would work cannot really be answered until it is attempted. However, I would suggest it is not an riskier than intermittent injections and may have the benefit of ease of use in situations where physical exercise really changes dramatically and unpredictably. I would suggest finding a physician who is comfortable treating him with a pump.
[Editor’s comment: We contacted the pump manufacturers and learned that all the newer pumps are IPX-8 approved (that is, watertight to a depth of 8 feet for up to 24 hours). So, I see no reason why your son would not benefit from one.
Natalie Bellini, RN, CDE of Animas suggests:
He could absolutely use a pump. We would want him to have two when he was overseas.Our pump is tested to 12 feet of water for 24 hours. I would have him wear it in the sports pack with a cool pack in the extreme heat so the insulin will not go bad. Finally, he will need Mastisol/Detachol for adhesion of the set and will need to change every days for insulin stability.
Brad Saks of Deltec writes:
This young man should do just fine with a Cozmo. It is waterproof out of the box with no additional cases. It is recommended for all surface water activities. All the kids at the CWD conference including myself swam and used the water slides, etc., all day long. Using Mastisol or another type of extra adhesive will prevent his site from becoming loose, but I would suggest bringing an extra infusion set to work just in case.
As far as heat is concerned I am not concerned about the pump but about the stability of insulin. Both Humalog and NovoLog can withstand temperatures of up to 98.6 degrees. I would suggest keeping his pump under wraps (out of direct sunlight) and in something cool and damp like a wet bathing suit pocket. I would suggest a cool pack, but it would get bulky, and from my outdoor experience it would be difficult to use. I keep my pump in my pocket wrapped in a wet washcloth if I will be in extreme temperatures. This usually keeps the insulin okay without too much inconvenience, but I have not been in temperatures over 100 degrees.
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