I am a fire fighter who uses a Disetronic insulin pump and Tender infusion set. I have frequently asked sales reps, Disetronic engineers in Minnesota and Sweden and lots of diabetes educators, at what temperature does an infusion set melt? I have never gotten a sufficient answer. The standard line is that insulin is not viable over 120 degrees Fahrenheit.
Could you please find an answer to this question that nags me every time I am exposed to extreme heat?
According to officials at Disetronic Medical Systems, there is no available data on when the tubing will melt. However, Jodi Lavin-Tompkins, RN, CNP, CDE, director of clinical services at Disetronic Medical Systems, says she knows of several fire fighters on Disetronic pumps who do just fine, with no problems.
“Your infusion set would be beneath all of your fire-fighting clothing, so anything that would get hot enough to melt the tubing would probably injure you first,” says Lavin-Tompkins, emphasizing that the greater concern should be for the heat’s effect on the insulin itself.
Patrik De Haes, MD, president of Disetronic, sees this as a theoretical question.
“It would have to be a very high temperature,” says De Haes, emphasizing that the infusion set can withstand greater temperatures than the person wearing the infusion set. “What I know is that the first thing that gets in trouble is the insulin inside the infusion set. The moment you put insulin somewhat over normal body temperatures, it starts being questionable in terms of viability.”
Can BG Improvement With a Pump Make My Retinopathy Worse?
I have severe retinopathy. I was hoping to go on an insulin pump but my endocrinologist says that rapid leveling of my blood sugar levels will hurt rather than help my eyes. Is this true?
Penola, South Australia
The Diabetes Control and Complications Trial (DCCT) did show that instituting intensive glycemic control could initially cause some worsening of diabetic retinopathy. This worsening of retinopathy was temporary and generally was followed by a reduced risk of progression of retinopathy. Since the DCCT did show conclusively that intensive treatment reduced the risk of onset and progression of diabetic retinopathy, we generally recommend instituting intensive treatment, provided the following conditions can be met.
- There are no medical contraindications to intensive treatment.
- Evaluation by a retinal specialist to determine level of any diabetic eye disease prior to instituting intensive treatment.
- Careful monitoring of any diabetic eye disease by a retinal specialist, particularly severe or worse nonproliferative diabetic retinopathy and any proliferative diabetic retinopathy.
- Close communication between the retinal specialist and members of the health care team.
The long-range benefits of intensive diabetes management have been clearly demonstrated for type 1 diabetes by the DCCT; similar findings for type 2 diabetes have been demonstrated by the U.K. Prospective Diabetes Study (UKPDS) Group and researchers in Japan. A decision to initiate intensive treatment or pump therapy should be made on an individual basis, in consultation with a retina specialist, endocrinologist and other members of your health care team. Careful monitoring of any level of eye disease by a retinal specialist is crucial, but the overall, long-term benefits of intensive therapy make this approach desirable for any person who is able to achieve tight control safely.
Jerry Cavallerano, OD, PhD
Beetham Eye Institute, Joslin Diabetes Center
What Do I Do With My Pump at Bedtime?
Where do pump users put their pumps when they sleep?
Morristown, New Jersey
Most people clip insulin pumps to their pajamas or just leave it loose in the bed and look for it in the morning. If they’re going to have sex, oddly enough, many people will simply throw the pump over the headboard to get it out of the way. Others advise either disconnecting the pump or leaving it under the pillow out of the way.
J. Joseph Prendergast, MD