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In case your infusion set accidentally becomes dislodged while you are in school, you should keep the following supplies in school:
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A bottle of insulin currently used in your pump should be kept in a refrigerator |
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A new infusion set and reservoir |
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Alcohol wipes |
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An insulin syringe or insulin pen (to give an insulin injection in case the cannula comes out accidentally) |
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Extra batteries |
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The phone number of your Endocrinologist and Diabetes Educator |
Some teens are concerned about wearing the pump during activities such as sports, dances, parties, and dating. For the most part, your pump will stay on for these activities. However, your Diabetes Educator will teach you how to go "off the pump" for showers, sports, swimming, the beach, and sometimes gym class. When you go off the pump, it is quite easy to disconnect the infusion set. Your Diabetes Educator will demonstrate how to do this, but it actually is as easy as a twist.
After the activity, wipe the connector end of the tubing with an alcohol wipe and reconnect the infusion set, and the insulin will again be infusing. Generally, if you are going to be off the pump for an hour or less (showers, short sport activities or gym class), you will not have to make any insulin adjustments. However, if it will be longer than an hour, then some dosage adjustments will have to be made. Remember to check with your Diabetes Educator for the adjustments that will be right for you.
Here are a couple of examples of what some teens do:
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If the pump is off for an extended period of time (usually more than an hour), it may be necessary for you to take a small bolus with a snack before removing it, or after reattachment, depending on your blood glucose level and the intensity of the activity. You will need to experiment to find the best snack routine for each particular sport. Blood glucose levels should be checked before, during, and after the activity to determine what changes are necessary.
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Initially, you might try a snack before an intense activity without a bolus dose, and the pump can either be removed, or placed in "suspend." If blood glucose readings are high, then you can try either a small bolus dose with the snack or skipping the snack. On the other hand, if blood glucose measurements are low, then you may eat a larger snack, and/or remove the pump earlier (so that you have less insulin working while you are playing). Your Diabetes Educator will help you with these strategies. |
Spending the day at the beach is another common issue that concerns teens using insulin pumps. You may prefer to remove the pump and tubing after taking the morning bolus. You will then need to take an injection of regular insulin at lunch (it might have to be larger than your typical lunch dose to cover the basal insulin that you are missing). Then reattach the pump before dinner. During your first few "pump free" beach days, it is a good idea to check your blood glucose mid-morning. If your blood glucose is going up, you may need an extra small injection at that time. Other teens prefer to take the morning bolus, disconnect the pump, and then reconnect the pump to deliver the lunch bolus. The pump can then be disconnected again until it is time for your afternoon snack. Once again, checking your glucose mid-morning is a good idea. You may need a larger dose at lunch to replace the basal insulin you were not getting while off the pump. Your dose will be dependent on the level of activity, so close monitoring of blood glucose levels is necessary to determine the proper bolus doses. Your Endocrinologist or Diabetes Educator will help you determine your optimal bolus dose.
Keep the pump out of the sun. When at the beach, put your pump in
a tightly sealed plastic bag, wrap in cloth and then in a cooler
with an ice pack or Frio pack, available from Diabetes Australia.
If you (girls) want to wear a 2-piece bathing suit, put the site
in lower, or try using your buttocks as a site. If you want to leave
the pump on, you can use the SportGuard™ hard case, worn over
the pump to swim. Otherwise, with a twist, you can disconnect your
infusion set. If you leave the pump off for more than an hour, check
blood glucose, re-connect and give yourself some more insulin according
to your blood glucose. To help the tape stay on better, put an extra
piece such as IV 3000 or Polyskin over the site, and when finished
swimming, dry off the site really well. Remember, if you are active
and you have removed the pump, always check blood glucose to determine
dose of insulin.
Occasionally, if your skin becomes wet or clammy (due to perspiration when exercising in warm weather), a rash could develop where the pump is touching your skin. If this occurs, you may want to invest in one of the cloth pouches that are sold for the pump.
When travelling, make sure that you bring extra pump batteries, insulin, pump supplies, an insulin syringe for injections and blood glucose testing equipment. A good rule of thumb is to pack double the amount of supplies that you think that you would normally need, just in case you were to have any problems (such as breaking a bottle of insulin). If you are travelling by plane, make sure that your diabetes supplies are in your "carry-on" bag that you take on the plane. Wear your pump through the metal detector. If you are travelling across time zones, change the pump’s clock to the "new" time once you arrive, and don’t forget to change it back when you return to your original time zone. If you are flying across many different time zones, (at least a four hour time difference), set a temporary basal rate at your lowest basal rate for the amount of time that you will be travelling, and take a bolus dose each time you eat. When you arrive at your destination, turn off the temporary basal rate, and change the clock of the pump to the "new" time. You should also check your blood glucose more frequently during the travel time.
Click Here for more information on Travelling with a Pump
Drinking alcohol and using an insulin pump is NOT
recommended. There are some safety concerns that must be
considered, as serious low blood glucose may occur many hours after
the drink is consumed. You should discuss this with your Diabetes
Educator or Endocrinologist.
Many teens who wear insulin pumps are initially concerned about dating. Some fear that they may not be asked out on a date if the person discovers that they are wearing a pump. While teens generally tell their closest friends, some teens may be reluctant at first to show their insulin pump to friends, especially those of the opposite sex. They may choose to conceal the fact that they use one. As you become more accustomed to the pump over time, you may feel more comfortable telling others about the device. Until then, your Diabetes Educator can help you to find ways to conceal the pump when dating. You also may be able to take the pump off during a date and take insulin injections. Talk about your choices with your Diabetes Educator. Formal night is often a dilemma for the pump user, particularly for girls. They typically wonder, "Where am I going to put the pump?" One solution is to wear the pump inside pantyhose against the thigh. Other girls have worn the pump attached to or inside their bra beneath their arm. The pump can also be pinned in a pouch to the inside of a loose fitting area of the dress, where it will not be observed. Again, it can also be removed for the evening, and meal boluses can be given with a syringe.
Remember that you have chosen the pump to have better control and to have more normality in your life. If you have any questions about fitting the pump into your busy lifestyle, talk to your Diabetes Educator so he or she can help you find the best ways to make pump therapy work for you!
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