Insulin Pump and Scuba

[Dvfrfsh]

I have read the similar post on this subject, but did see any mention of complications with infusion sites. Has anyone experienced anything with the pressure and infusion sites? Is it something I should worry about?
I see that people are able to be on the insulin pump, and capable of diving. I am still a needles managed (Type I) Diabetic, but was thinking of going on the pump. I was unsure to take the leap for fear of not being able to SCUBA dive. The main fear I had was the pressure and catheter spot for infusion. Does the pressure effect that at all? I will be honest, and say i really have no experience or clue on exactly a pump works. All i know is that many people swear by them, and was thinking of taking the plunge.

Any help would be appreciated,

Thanks!

Derek

[DocVikingo]

Hi Derek,

To the best of my admittedly limited knowledge, even the hardiest of these pumps are not rated for use beyond shallow depths. All manufacturers of which I am aware indicate that their units are not designed to be used while SCUBA diving. Even units with waterproof cases typically are only tested and approved to ~10-15 feet. I have heard several stories of pumps falling apart at depths in the 20-30 foot range. Moreover, even given a system that could withstand significant depths there are other issues. Divers I know who are on pumps disconnect and leave them topside while diving.

"The Un-Tethered Regimen" (http://www.childrenwithdiabetes.com/clinic/untethered.htm), written by a well-known diabetologist who has the condition himself, provides a protocol for controlling bg while diving, amongst other physical activities.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.

[D_B]

May be slightly helpful:
I have a friend who has an implanted pump (not for insulin) and has asked the manufacturer/doctors about resuming diving .. their advice was stay above 30 feet

[cutlass]

Here's a related post which I believe has application to most implantable devices link (http://www.scubaboard.com/forums/5137463-post2.html) Basically, there is a construction standard of sealing pressure and it's generally 2atm/10m. Of course, imposing a respectable safety margin would mean something far less; something like 10-15' mentioned by DocV would make sense.

[Duke Dive Medicine]

Derek,
Dr. Freiberger and I are going to do some research on this for you. One of our diabetologists here at Duke is a diver who has presented at DAN conferences, so we'll consult with him and get back to you in the thread with what we find out. For now, I'd recommend reading the UHMS/DAN guidelines on diving with diabetes if you haven't already. They're linked below.
Rubicon Research Repository: Item 123456789/5538 (http://archive.rubicon-foundation.org/dspace/handle/123456789/5538)
Best regards,
DDM

[Duke Dive Medicine]

Derek,
After consultation with Dr. Guy Dear, one of the principal authors on the above referenced paper, we have the following recommendations for you:

1. Do not dive with the pump attached, even in a drysuit. As far as we know, none of the insulin pumps available are rated to diving depths.
2. Decannulate the site prior to diving. There is a risk for infection, irritation or inadvertent decannulation of the insertion site if you leave the access device in. After diving, choose another insertion site and clean it well before you recannulate.
3. Follow the recommendations from the UHMS/DAN guidelines for diving with diabetes.

In his study, Dr. Dear had several diabetics with insulin pumps and their glucose control was as good as, or better than, those who use intermittent insulin injections.
I hope this information is helpful. Please feel free to PM me or post here if you have any other questions.
Best regards,
DDM

[bvanant]

I have read the similar post on this subject, but did see any mention of complications with infusion sites. Has anyone experienced anything with the pressure and infusion sites? Is it something I should worry about?
I see that people are able to be on the insulin pump, and capable of diving. I am still a needles managed (Type I) Diabetic, but was thinking of going on the pump. I was unsure to take the leap for fear of not being able to SCUBA dive. The main fear I had was the pressure and catheter spot for infusion. Does the pressure effect that at all? I will be honest, and say i really have no experience or clue on exactly a pump works. All i know is that many people swear by them, and was thinking of taking the plunge.

Any help would be appreciated,

Thanks!

Derek
First a disclaimer, I work for Medtronic and was one of the inventors of external programmable insulin pumps. Many friends wear pumps and are divers. You definitely don't want to wear the pump while diving, that is a bad idea for many reasons, not least of which is that you will kill a $5000 device. Pumps are not designed to be waterproof let alone dive worth. There are many infusion sets available to use with pumps but none of them have been tested for high pressure applications, so I would recommend removing the infusion set before going into the water and replacing it after the dive day is over. If you are going to be doing lots of diving (Like every day) then I would recommend that you use the bent needle infusion sets which can be removed and replaced quite easily; using the typical teflon cannula sets might get very expensive. You should of course test before going in the water and make sure that you are in good control before the dive and test again right after you get out. Hypoglycemia underwater is not my idea of great fun but severe hyperglycemia can be just as bad.

Overall, I would strongly recommend that you take a serious look at pumps; your control will be better and many modern pumps can talk to continuous glucose monitors to give you a much better sense of how your control is going than even 6 or 7 finger sticks a day.

Bill

[Dvfrfsh]

Thanks a bunch guys! This has been a real help. I plan on getting a pump, and am glad that it will not restrict my diving.

Thanks again!

Derek

[DocVikingo]

You're welcome, Derek.

If I hear anything new, I'll let you know.

Best of luck and enjoy SCUBA.

Regards,

DocVikingo