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When I did the ‘equivalent’ (race for life in mud) I took my pump off as I didn’t want to get it absolutely covered in mud and have to figure out how to get the mud out of all the little crevices afterwards.
I took an insulin pen with me, a glucose meter in both in a waterproof type bag inside a backpack and just pricked my finger every so often and injected as needed during the run. I also took lots of hand wipes so I could get the mud off my fingers when I needed to do a check. I had it all in a small backpack as you were allowed to take them with you. Not the most convenient but it’s what worked well for me and if I did TM I’d probably do the same thing.