Diabetes

The Best Insulin Pumps for Diabetic Swimmers

My love for the water  – swimming, sailing, diving, training – remained steady after I was diagnosed as a child, and has been constant for nearly four decades.  I find comfort in the sea and in a pool where worries of the day melt with each stroke.  I feel strong in the water; my worry with diabetes abates when I am in motion.  I feel empowered in the waves.

This past weekend I noticed a significant change.  I was trembling as we made our way toward Tai Long Wan, an outpost of Hong Kong’s New Territories, which is well worth the 60 minute trip for its beautiful beaches and clean water.  I felt panicked as the boat jumped up and banged down with 4-6 feet swells in the China Sea.   As we motored our way through inlets and coves and then out into the open ocean, I sensed danger and noticed an increase in the force of the whitecaps hitting the rocks.  The wind was picking up, too.  The runner boat accommodated 12, and my 10 year daughter and her friend were on board.  When I looked over to where they were sitting, I noticed they were happily rollicking and laughing while the spray of the ocean tickled their faces, but I was uncomfortable.  For the first time, anxiety and fear replaced usual enjoyment.

The open sea - not a safe place for a non-waterproof pump

This fear may been growing now for sometime since I resumed my water sports with a pump.  For many years I wore an insulin pump in New York and London, but was actively engaged with my career and the urban gym for sport.  Now that I live in the tropics, I swim a lot.  After giving it some thought I realize that my fear has to do with my utter dependence on the pump for keeping me well, and my fear of losing it in the water.  What if I fall in the sea?  The (Medtronic) pump will become inoperable within seconds.  It’s an irrational fear because the pump is replaceable and I am a strong swimmer.  My fear is not related to drowning, I am afraid of losing the piece of technology that keeps me alive.

In light of this, I have decided to look at my options as a type 1 adult with diabetes who utilizes pump therapy but relies on the water for exercise (keeping muscles healthy for insulin uptake) and pleasure.  With my current pump, I can disconnect for no more than 1 hour, and disconnecting is not easy for me.  Inevitably, after 30 minutes or so,  my sugar begins to rise.  (I take a max of about 25 units a day).  This lack of freedom both in and around the water is frustrating.  Essentially, I have two other options to assess… so here we go:

OMNIPOD
OmniPod came onto the market in 2001, and today, roughly 27,000 patients utilize the OmniPod system.  “The Pod integrates the pumping mechanism, cannula, needle, and insulin reservoir into one wearable unit. The PDM (Personal Diabetes Manager) wirelessly programs insulin delivery, calculates suggested doses, and has a convenient, built-in FreeStyle® blood glucose meter,” says the wensite.   It’s IPX rating is 8 which means it is water tight and safe to wear in water for up to an hour.  Off record, I know a few competitive swimmers who will use it for up to 2-3 hours and even more.  They swear by it.  One issue for a few individuals is that the adhesive will not stay on skin and after a few minutes in the water, will fall off.  Pods are expensive – 29.90 US apiece – so it isn’t something you can easily discard.  One great selling point for the ‘Pod is that you can trial it – it does come with a money back guarantee.  I like that.   I like the fact that if I  keep the PDM by the pool while I train, I still receive my infusion.

PROS:  Best on market for swimmers.  Safe for one hour in water, maybe more.  Continuous infusion.
CONS:  Expensive (if insurance doesn’t cover you).  Adhesive may not always work.  (Not available in Europe, Asia… yet!)

Be careful with some brands!

ANIMAS
The Animas model has many similarities with Medtronic but there is one very important differentiating characteristic.  It is waterproof!  It has a waterproof guarantee which essentially means that if it fails because of being dropped, dunked or submerged in water – it is replaced for free.  It has been tested and proven waterproof up to 12 feet of water for 24 hours “so you can jump in the pool or get caught in the rain without worry” says the Animas website, but the customer service technician I spoke to mentioned that she wasn’t aware of people “doing laps” with the Animas or even swimming with it.  This makes me curious.  I wonder if there aren’t indeed people who are using it for more rigorous water sports rather than seeing it as a piece of technology that is merely safe to use around water.  I understand how it is a verifiable life-saver for parents with children – who in their excitement to go swimming – may forget they have a pump on and jump in the pool.

PROS  It is guaranteed waterproof.  It has the One Touch Ping which has everyone raving.
CONS Unclear if it can be truly utilized for swimming. (Not available in Asia and I’ll say it again, YET.  Next market Saudi Arabia)

In summary, Medtronic is the least appealing pump for a swimmer as it is neither waterproof (IPX rated for submersion in water for 30 minutes in 1 foot of water) and obviously, it must be disconnected if you want to swim.  Medtronic is also the most widely available pump in the world with distribution in China.  Animas is guaranteed waterproof, but it is not clear how user-friendly it is in a pool for laps.  OmniPod is by far the clear winner for swimmers, but it is not integrated with any CGMS technology. Each of these pumps has a strong position in the market – Medtronic for the Carelink System and integration with CGMS (Continuous Glucose Monitoring System); Animas and the One Touch Ping + waterproof guarantee and finally, OmniPod for the best design and enhanced freedom.

If only I could get all these benefits in one.

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