Time Travel With An Insulin Pump

February 17, 2013 6:18 PM

My wife, who has had an insulin pump for almost 18 years, has somehow never traveled more than one time zone with it. Next week she has 5 day business trip to the West Coast, and we live on the East Coast. Any diabetic MeFi's have experience crossing 3 time zones with a pump?

A complicating issue is that I got laid off on 1/31 so we have no insurance at the moment and her soon to be former endocrinologist refuses to help her without a full office visit that he can charge us $500 for. Further complicating is that she has 11 changes in basal rate over 24 hours. Our thought is to wait until she lands, then set her pump clock to PST and set a temporary basil rate for 3 hours at the lowest rate from the preceding 3 hours (if it jumps around significantly during travel time.). That way she minimizes the extra insulin she might get and minimizes the chance of a serious low.

Does that sound like a decent plan?

Coming east seems like it'll be easier as she gets in at 11:30 PM local time so she can simply fix her pump clock when she gets here. After 21 years of marriage I have an uncanny ability to tell she is getting low, before she evens feel it.

posted by COD to Health & Fitness (7 answers total)

IANAD, but I am a type 1 diabetic whose been wearing an insulin pump for almost four years, and I've made that same trip a number of times.

Generally, I wait until about halfway through the flight or so and then set my pump ahead (or behind, depending on which way I'm flying) to the new time zone. That's what my endocrinologists have always recommended, and it seems to work fine. It seems to help my body acclimate to the new time zone.

I generally find that, instead of going low, all the sitting on a flight can make me go a bit high such that I sometimes have to give my self extra boluses to come down. So she might not have the issues of going low that she's afraid of.

I've flown quite a bit with my pump across a lot of time zones (from LA to central, to eastern, and to Europe), and ultimately I end up just checking my blood sugar a lot (every hour or so and more if I'm feeling at all off). Does she have a CGM? Because obviously that would help a lot in trying to figure out whether she's holding steady or going low or high.

Good luck! If you have any more specific questions, feel free to memail me. I'm happy to help!

Finally, $500 for an office visit?!?! That's insane. I pay cash for my endo, since she's not in my insurance plan, and she charges $50 for an office visit. And that's in LA. Your wife definitely needs to find a new endo.
posted by McPuppington the Third at 7:41 PM on February 17, 2013 [3 favorites]

There should be an 800 number on the pump or, failing that, on the pump packaging. My diabetes educational counselor is one the people whose job it is to answer those kinds of calls, day or night, and provide exactly the guidance you're seeking.
posted by The Wrong Kind of Cheese at 7:55 PM on February 17, 2013 [1 favorite]

For West Coast business trips of a few days, I usually just don't adjust the time at all. This stance is concurred with by my endocrinologists (who thinks my basal profile is complicated, and it's only half as extensive as your wife's!)

For a recent trip to Australia, I was advised to adjust it six hours at a time, max. I did adjust it when I changed time zones by three hours in Australia.
posted by stevis23 at 7:59 PM on February 17, 2013

I'm type 1 and have traveled coast to coast, as well to Europe with an insulin pump. My usual rule is to change the pump's time by one hour per day. So on the day of the flight to the west coast, I would move the time back one hour, then one hour on the next day, and finally sync up on the third day. This has seemed to work well for me (and seems to correspond with how my internal body clock feels as it adjusts to the current time zone), although I definitely combine it with even more obsessive glucose checking than usual.

I also have a lot of basal rate variation, for what that's worth - on a typical day, for instance, I range from 0.8 around 6 am to 0.15 at 4:30 pm, with a total of 12.7 over a 24-hour period.

While actually on the flight, I too seem to be high more often than not, like McPuppington the Third. I attribute this to anxiety about flying. Your wife may be different, but either way I wouldn't be too hasty to make basal changes based on what happens during the flight itself. Also I remember reading somewhere that the pressure changes in an airplane can actually have a significant effect on the function of an insulin pump - I believe the article even recommended briefly detaching and then repriming in order to adjust while in the air, and then doing so again upon landing. I've never actually done that, but it's interesting to think about.

If you want to hit me up with specific questions, also please Memail me. Every time I compare notes with somebody else in the same situation, I always learn something myself! Good luck.
posted by chinston at 8:16 PM on February 17, 2013

My husband is type 1 and has a MiniMed Paradigm. He doesn't have a lot of variance in his basal rates, but he also tends to run high when flying. So that's another data point for running a bit high during the flight itself.
posted by RogueTech at 10:08 PM on February 17, 2013

Best answer: I am type 1 with a Minimed Paradigm. I have flown cross country any number of times with it, including while pregnant and taking insane amounts of insulin. I've always just set the time zone when I land, and have never had any problems at all. Or, at least, any problems I have had (running a bit high, as others have said) I've attributed to trying to carb count crappy airport food.
posted by kestrel251 at 9:00 AM on February 18, 2013

Response by poster: Apparently when they changed the dates of Daylight Savings Time AZ did not go along, so it is only 2 hours behind the east coast in the winter. So the trip ended up being a non issue for diabetes.
posted by COD at 10:13 AM on March 8, 2013