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How to travel with a insulin pump?

Jhon Doe

Jhon Doe

Member
Messages
6
Type of diabetes
Type 1
Treatment type
Pump
Hello everybody, I am diabetic from I was a child. Three years ago (that will be the 3 years in two months) I begun to use to insulin pump (MiniMed 780G). I can tell you a lot of stories about this time, but I don't think they will be entertaining for anyone.
Before that I was a person who was diabetic. Now I am only diabetic. Glycosylated levels are perfect, but a lot of things that I would do it, now I don't know how to do it. Now for me it is difficult to go further than about 30 minutes from my home: well, really impossible. My experience is: if something bad can happen with the pump, it will, and when you least expect it you'll can fix the problem. Then, of course, you cease to be a person and are simply diabetic: I don't have time for more.
Since I started using the pump, I've only eaten out twice. I prepare everything else at home: I weigh, calculate the carbs, cook, and then, after setting the carbs, I wait until my glucose levels are low enough so I don't go out of range.
I've always loved eating, but it's so tiresome to prepare all the meals every day, so I've lost the pleasure of eating. And besides, with breastfeeding, eating isn't essential. You can just not eat, and that's fine. And that's also been reflected in my weight.
I've always loved eating, but it's so tiresome to prepare all the meals every day, so I've lost the pleasure of eating. And besides, with the pump, eating isn't essential. You can just not eat, and that's fine. And that's also been reflected in my weight.

There are 3 years that I don't go more far a 30 minutes of home. I would like contact with people that tell me how that do when they do when they travel. How do you count the carbohidrates outside of home (because this the only way to say to pump how much insulin should it inject to you in Guardian mode)? And what they do with something go wrong and they aren't at home?

And the last, I decided, at end, that I could fly (becasuse I I was quite anxious when I had to show the airport police everything the pump requires and which parts are connected to the body and not easily removable (if you disconnect the sensor, it takes two hours to reconnect). At that moment, I received an email from Metronic, informing me that if you fly with the pump (and explaining which models, including the one I use), you could experience problems:

Dear Medtronic Diabetes Community Member:

Medtronic is contacting you to inform you of an Urgent Safety Notice regarding your MiniMed™ insulin pump. During quality testing conducted by Medtronic, we recently discovered that changes in atmospheric pressure can cause unintentional insulin delivery. For example, atmospheric pressure on an airplane can change rapidly during flight, which can cause small air bubbles to expand inside the insulin reservoir. Problem Description:
When atmospheric pressure decreases (for example, during takeoff), more insulin than expected may be released. Additionally, insulin may be unintentionally released even if the pump is stopped or programmed to zero units per hour.
When atmospheric pressure increases (for example, during landing), less insulin may be released than expected.
Health Risk:
Changes in atmospheric pressure may cause more insulin to be delivered during takeoff, which could cause hypoglycemia, or less insulin to be delivered during landing, which could cause hyperglycemia.

Between July 2003 and May 2024, Medtronic received 138 incidents that could be related to this issue, 19 of which reported serious injuries, although none of them have been confirmed to be related to this issue.

It is important to monitor glucose levels frequently during the flight and be prepared to treat hypoglycemia or hyperglycemia. People with lower daily insulin doses and those with high insulin sensitivity may experience greater changes in glucose levels during changes in atmospheric pressure than people with higher insulin doses and/or lower insulin sensitivity. If you are unsure whether this applies to you, it is important to seek guidance from your healthcare professional regarding treatment.

Recommended Actions for Pump Users:
Monitor your glucose levels: Check your glucose level frequently when traveling by plane, riding amusement rides, or in other situations where sudden or extreme changes in atmospheric pressure, altitude, or gravity may occur.
Talk to your healthcare professional about how to prepare for these types of situations. Always have an emergency kit with fast-acting glucose and backup insulin on hand.
Respond to alerts and symptoms: Pay attention to any alerts from your pump, as well as symptoms of hypoglycemia or hyperglycemia. Follow your healthcare professional's treatment instructions in these situations.

I assume all Metronic users have received it.

Thank you, dear forum user, for taking the time to read what I've written. I'd like to know if this is the place I'm looking for to share my experiences and get some answers.
Greetings to everyone on this forum.
 
Welcome to the forums @Jhon Doe :)

In terms of short travels, I usually take an infusion set and some insulin with me just in case (including a pen) - My workplace is around 30 minutes from home so I always keep extra sets and insulin there - In my 5 years of being there I've only ever needed to actually use the extras a couple of times - same for day trips I usually just take extra sets, some insulin and a pen with my short acting insulin in at least then if something does go wrong I've got supplies. I also always take a blood glucose meter, no matter where I go/am.

For longer travels such as abroad or even short breaks away in the UK I have a whole list of things I take, I usually write the list before I go to make sure I take everything and always carry it in my hand luggage on a plane as you don't want it to get lost they always say to take around double what you'll actually need - I take all my pump/cgm supplies (infusion sets, insulin, batteries, charger, inserter, sensors) Incase of pump failure I also taken Insulin pens, Insulin cartridges, pen needles. I always take a blood glucose meter and test strips and a ketone tester and test strips and lots of low blood sugar supplies.

The amount of times I've travelled abroad (and its a lot since having diabetes) I've never had a pump failure, not to say that it can't happen because I'm sure it does but I always prepare for the fact that it may happen and take the needed supplies for if it does because Medtronic cannot always guarantee they can send a replacement pump to your location.

Carb counting is always difficult when you're out and about most restaurants will usually have a nutrition value menu that will give you the carb values, if they don't (no one hate me) but I guestimate how much, when I first started carb counting I was taught 10g of carbs is roughly the size of a medium egg how true that is I don't know but I base my values off of that - Some people use the carbs and cals app to estimate how many carbs in meals and it does seem rather useful it's just something I've never gotten on with but it may help you. At the end of the day, you can't get things right 100% of the time with carb counting and that's okay, if you get it slightly wrong you can correct later, don't let fear get in your way of having fun!

I also received the above alert from medtronic, some people during take off will unplug their pump during take off to reduce the risk of extra insulin being pushed through. Personally, I don't and have never had any issues, but if it worries you I'd recommend disconnecting until you're at cruising altitude.
 
Thanks @Raquex for your kind welcome. I not only expect help, I will try to help with all my experience to others. I don't replay you before because I was writing my presentation in the group. And it took me more of time that I hope to do it :rolleyes:.

Thanks very much @Nicola M to your detailed explanation, with so much information and real-life examples, I can get a good idea of how to do it. I'll need to reread it several times to fully grasp everything. Even so, I already have some questions (based on your answers). But I'll ask them another day. I'm a newcomer today, and I'm very grateful that you've gave me part of your time to help me.

I'm really liking the group. I hope it's reciprocated and that your group likes me back.
 
Hi @Jhon Doe and welcome to the forums.

I think @Nicola M 's reply covers everything, but I'll add my experiences, just to confirm people can travel with a pump.

I'm a pump user, but not a minimed one, but I do sympathise about the extra kit needed if travelling. Though I've only had my pump for 18 months I have travelled a lot with it. And yes, I could make a big list of things that can and have gone wrong with my pump, but that just means I carry extra when I travel (extra sensors, glucometer for when the sensors fail, insulin pens for if my pump fails, extra insulin and infusion sets).

Are you maybe trying to be too perfect with your blood sugars??? As long as you have plenty of glucose with you, I believe there isn't that can be much worse with pump treatment than it was without it. Personally I went onto the pump because I was getting too many hypos with MDI, and my pump has radically reduced them.

As for the plane thing, I believe that is a feature in most pumps? Tandem certainly recommend you turn insulin off in unpressurised flights. I regularly fly long distance (I'm in New Zealand and my family are in the UK and Australia). My main flight recommendation, other than having your diabetic supplies in your hand luggage (my husband carries some of it on long trips which need lots of supplies) is to make sure your glucose is in a pocket accessible at all times. Having hypos in the airport is no fun, and having hypos in the plane is even worse if your glucose is in an overhead locker and the fasten seatbelt sign is on.
And the altitude issue has been known about for years https://pmc.ncbi.nlm.nih.gov/articles/PMC3161261/

As for carb counting restaurant meals, I generally guess, though I sometimes weigh stuff at home so that I can keep my guessing more accurate. I was diagnosed when 8 so was old enough to carb count from the start and memorise the carb content lists, but I don't always remember accurately now. Full disclaimer, my levels are nowhere as good as yours but I always regard it as a work in progress.

Once more welcome. (Bienvenido)
 
Thank you @EllieM for your kind response. And I'm extremely grateful for adding your personal experiences, which are what I was truly looking for. And you're right, one of the parts that has driven me to near despair is trying to get the pump to achieve 100% in-range time (which is impossible because the sensor changeover time means that even if you're 100% in-range, for the pump, the time that lasted the sensor changeover hasn't been in range). So the most I've achieved has been between 95% and 98% in-range time (and I've also been in that time in range because I do blood tests every 30-45 minutes, depending on how high/low my glucose is).

I wanted to start using the pump to improve my health for the future, because my body, after more than 58 years of diabetes, has, apart from age-related problems, diseases caused by diabetes itself: cardiovascular problems, poor circulation in the extremities, diabetic retinopathy, and several others, all due to this disease. And above all because I have a wife whom I love her very much and I don't want her to suffer as a consequence of my disease (and she already suffered greatly when, before using the pump, I had more of one very severe hypoglycemia). But she always tells me that "You can do whatever you want", and if I'm so fed up with the pump (in December-January I reached the point of maximum desperation), that I should stop to use it (she knows all the time I dedicate to it to stay in range and not have problems in the future). But she also realized how desperate I was: that I wasn't sleeping because the pump wouldn't let me, that I wasn't eating because the pump wouldn't let me, that the Metronic people weren't giving me any solutions, and that I should ask my endocrinologist. And my endocrinologist, said every time that I was to see him and I showed him last blood test, he told me that all was perfect: the glycation of a "prediabetic" person and all the other test values were adequate.

Of course, to get to that point, I almost gave up my life and my will to endure it. My wife, who was seeing how I was feeling, told me: "You can leave it right now, if you wanted." But I also remembered the glycated values before the pump, and one more thing: to this day, I don't know how much insulin I need as a basal. With my current diet, the table I initially set up a pump, which fits my lifestyle, now has double the number of insulin units the pump injects in Guardian mode. I also asked Medtronic that I need those basal infusion values and how can I get them, because if I the pump broke one day, I won't know how much insulin to inject. And a very kind person told me they would look for them for me (because I couldn't find them in the data they give us access to). And the only thing he found was the same thing I did: additional boluses. So, for now, I don't see a way out if I want to stop using the pump. And if I need to stop (because the pump has temporarily stopped working), I don't know how to do it either. I've tried to be concise, but I have so many things that I can't tell anyone because they don't understand and because I never tell anyone that I'm diabetic, may have been too much as an answer for you. I just wanted to thank you very much, your a kind, pleasant, and inspiring response. I'd like to tell you that this is the abridged version :rolleyes:.

I've created another (the first version of this document), much longer document that I'll post in the coming days because, speaking of the bomb, I've gone on about all the problems, and this wasn't the right thread because I asked a very specific question.

Thanks again (and your greeting at the end of your message is very much appreciated :). I try to be as accurate as possible in Shakespeare's language, but I'm happy just to try to make as few mistakes as possible).
 
Unfortunately I'm not a medtronic user so can't help you with medtronic specific problems, but my (limited) understanding was that the pump learns from your needs, so that it may go out of range when your needs change, it is supposed to get you back to normal eventually.

Tagging @searley who is also on the 780g, which I believe he prefers to his previous tandem.

But the forums are there for you to share information and support with other diabetics and friends of diabetics, so I hope they are able to give you some assistance, even if it is only to get moral support.
 
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