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Unintended Insulin Pump Delivery in Hyperbaric Conditions.

Unintended Insulin Pump Delivery in Hyperbaric Conditions.
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Bertuzzi F, Pintaudi B, Bonomo M, Garuti F,


Bertuzzi F, Pintaudi B, Bonomo M, Garuti F, (click to view)

Bertuzzi F, Pintaudi B, Bonomo M, Garuti F,

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Diabetes technology & therapeutics 2017 02 23() doi 10.1089/dia.2016.0368
Abstract
AIMS/HYPOTHESIS
Unintended pump insulin delivery was reported to occur as a consequence of decreased atmospheric pressure, probably mediated by air bubble formation and the expansion of existing bubbles. This observation has been used to explain some hypoglycemic episodes occurring in patients on insulin pump treatment in between 1 and 1 h 45 min after the flight takeoff. New models of insulin pumps have been introduced in the market, most of them are waterproof certified. It is not clear if in these new pumps the influence of atmospheric pressure changes on the insulin delivery is still present. Moreover, there are no evidences related to the insulin pump operations in hyperbaric conditions, like as during diving activities. Our aim is therefore to verify the eventual variation of insulin pump delivery determined by atmospheric pressure changes in hyperbaric conditions.

METHODS
Three new models of insulin pumps were tested in hyperbaric conditions at a flow rate of 2 U/h.

RESULTS
Atmospheric pressure variation affected pump insulin release. An increase in the atmospheric pressure from 1 to 1.3 atmosphere (ATA) induced a decrease of pump basal insulin release (about -0.2 U/10 min); conversely, when the atmospheric pressure returned from 1.3 to 1 ATA, an unintended insulin delivery was observed (about +0.3 U/10 min). This phenomenon appeared to be independent of the insulin pump rate and dependent on the presence of air bubbles within the insulin tube setting and cartridge.

CONCLUSIONS
Unintended insulin delivery driven by atmospheric pressure changes in hyperbaric conditions occurred in the new insulin pumps available. Patients should pay attention to possible variation of insulin rate during the flight or during diving activities.

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