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Thinking of disconnecting from your insulin pump?

Those of us who wear an insulin pump receive a pulse of rapid acting insulin approximately every 3 minutes, also known as our basal rate. Our pump is programmed to deliver this “background” insulin, and when programmed correctly, this keeps blood glucose in check around the clock, independent of bolusing for food intake.

Patients may choose to disconnect from their insulin pump when showering/ bathing, exercising, during intimate moments and when swimming.

What happens when we disconnect from the pump, thereby interrupting our basal insulin delivery for a time?

A recent study was conducted to research exactly that. Published in Diabetes Care 2008, it monitored the effect of a 30 minute disconnect.

The blood glucose values were measured one hour prior to disconnection and for the following 4 hours. What was the effect on the blood glucose following a 30 minute disconnect?

The results were interesting and may surprise those of us that disconnect intermittently.

Graph adapted from Quantifying the Impact of a Short-Interval Interruption of Insulin-Pump Infusion Sets on Glycemic Excursions. Howard Zisser. Diabetes Care February 1, 2008. Volume 31, Number 2. P. 239 Nineteen subjects with Type 1 diabetes were studied. One hour after arriving at the clinic in a fasting state, subjects temporarily disconnected from their pumps at their infusion set site, interrupting basal insulin infusion for 30 minutes. Subjects rested in a fasting state for an additional 3 h after reconnecting, and glucose levels were monitored for an additional 4 hours.

Notice from the time action graph that a 30 minute disconnect does not greatly affect blood glucose concentrations during this period. Pump users may well experience this themselves - disconnect your pump for 30 minutes and nothing much happens in terms of blood glucose rise.

Most interesting, however, and something for the pump user to consider is the delayed effect on blood glucose levels. Mean blood glucose was significantly higher at 3 and 3.5 hours following disruption of basal insulin for 30 minutes.

It was concluded that the 30 minute interruption of basal insulin resulted in significant glucose elevation. The rate of rise in glucose concentration was 1 mmol for every 18 minutes insulin infusion was interrupted.

The clinical trial also indicated that “Patient education should focus on when and how to safely disconnect infusion sets and discuss the likely impact that disconnecting has on glucose levels.”

Always follow your healthcare team’s individual guidelines when disconnecting your pump because you may need to compensate for missed basal insulin. Before and after you disconnect for any length of time, remember to check your BG levels.

The information made available on the Animas website is not intended to be used or viewed as a substitute for consultation with a healthcare professional. The information provided on this site cannot be the basis for diagnosis or therapy. You are advised to obtain professional advice and should always discuss your treatment plan with your healthcare team. AN 10-836A