A Swimmer/Lifeguard Seeks Advice on Switching to an Insulin Pump
Patriotic lifeguard tower, Miami Beach. Photo taken May 2011.
Recently, a seventeen-year-old high school swimmer who spends her summers lifeguarding emailed me looking for advice on making the switch from daily shots to an insulin pump. I wanted to share our correspondence, as I know there are others out there who might be wondering if an insulin pump is a good fit for someone who is in the water a lot. If anyone else can offer any tips or advice, or has experience with a waterproof insulin pump, please share in the comments area below.
Hey Kevin,
I was curious if you had any advice about the switch between insulin to the pump. I am seventeen years old and have had type 1 diabetes for a little over a year now. I too am using Lantus and Novolog and am a little worried about the switch seeing as I am a high school swimmer and a lifeguard over the summer, so I spend a lot of time in water. Will that affect me?
Anonymous,
Personally, I have found the switch from Lantus and Novolog shots to the pump to be very beneficial. The biggest advantage is that I am better able to control my insulin dosage with the pump, as it more closely (but not exactly) mimics a normal insulin-producing pancreas. Lantus has a tendency to pool under the skin causing its absorption rate to vary. This inconsistency increases your risks for unpredictable high and low blood sugars, which I had been experiencing a bit prior to making the switch myself.
With an insulin pump, you are delivered a steady stream of Novolog (or other fast-acting insulin) throughout the day (called the basal rate). This rate can be adjusted depending on how much insulin you need during certain times of the day, and you can set a temporary delivery rate (temporary basal rate) during times of increased exercise when you may not need as much insulin.
Another big advantage to the pump is that you can give yourself more exact doses of insulin. With the Novolog pen for example, I used to do a ratio of 10 grams of carbohydrate = 1 unit of insulin (your own ratio may be different). The problem is that if I was going to eat 16 grams of carbs, I would have to either round up, shoot 2 units, and risk going low later; or round down and shoot 1 unit and risk going high. With the pump I can give myself a precise dose of 1.6 units of insulin, which should almost exactly cover my 16 grams of carbohydrate (provided my own ratio is correct). So, the fact that I can do fractions of units with the pump is in my opinion a huge advantage over the Novolog pens.
With regard to swimming, please don’t let that dissuade you from making the switch, as there are definitely options for you. I personally use the MiniMed Paradigm Insulin Pump, but it cannot be submerged in water, so I can’t wear it to swim. This is usually not a big deal because since I’m exercising, my blood sugar usually drops while swimming anyway, so I don’t need much insulin during that time. However, I don’t swim very often, so for me it’s not as much of a daily factor.
A better option for you might be the OmniPod Insulin Pump, which is waterproof and can be used during swimming. As a lifeguard, this would allow you to not have to worry about having to detach your pump (or jump in with it and damage it) as you make a save. Even though it only takes a second or two to disconnect the MiniMed pump (my type of pump) from your body, as a lifeguard that second or two could make a huge difference. So, in your case, I would definitely look into the OmniPod insulin pump mainly for the fact that it is waterproof. I have never used it but I imagine it’s similar in other ways to the MiniMed that I use, at least in terms of administering doses, basal rates, etc. Here’s a link to the OmniPod website ( http://www.myomnipod.com ). You should also check out the blog Too Sweet ( http://waytoosweet.blogspot.com ). That blogger’s daughter uses the OmniPod and is shown swimming with it. I imagine that the blogger, Amy, could answer questions that you may have about that specific type of insulin pump.
On a side note, I also use a CGM (continuous glucose monitor), which attaches to my body and is completely waterproof. I have swum with it both in the ocean and in pools. It has also been very helpful for me in managing my blood sugar and in predicting potentially dangerous lows and highs before they occur.
In conclusion, you should definitely discuss your options in length with your doctor. Be careful because some doctors work with specific insulin pump distributors more closely than others and will push to give you a pump that might not be best for you. Make it clear that you are a swimmer and a lifeguard and that you need a reliable (most likely waterproof) pump that will work best for your lifestyle. They should be able to set you up with a rep from OmniPod who can answer all of your questions and give you a demonstration. There may be other waterproof insulin pumps on the market, but the OmniPod is the one I’m aware of.
Best of luck.
My name is Kevin Lang and I am a Type 1 Diabetic who was diagnosed in May of 2004 at the age of 27. My last A1C was 6.0 in May 2015. I used to use daily shots of Lantus and Novolog to control my blood sugar until I switched to the MiniMed Paradigm Revel Insulin Pump in February 2011. To learn more about me, follow the about link in the menu bar.