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Summer is here and that means countless opportunities for swimming in pools, lakes, rivers, water parks, the sea and much much more.
Some people can feel a little apprehensive when it comes to swimming with diabetes: will it drop my blood sugar? Is my insulin pump waterproof? Is my CGM waterproof? Don’t fear.
Here is my guide to swimming with diabetes whilst on holiday.
This will fully depend on the type of swimming you are doing. Of course, swimming is a form of exercise and any exercise has the potential to bring our blood sugars down. However, if you are relaxing in the pool, paddling, or doing gentle swims, then the chance of the activity bringing your blood sugars down is quite slim, however, if you are in a hot climate, then the heat too can bring your blood sugars down so you should exercise some caution.
If you are swimming in the sea, then the chances are you are battling against some waves (especially if you are swimming/surfing in the sea!), then it’s more likely this will impact your blood sugars.
Basically, you need to work out the level of physical activity you will be doing and adjust. If you are on insulin pens then you can either reduce your background insulin or reduce your bolus meal insulin. If you don’t want to reduce anything, then you can consume more carbs to try and combat the physical activity from swimming.
If you are on an insulin pump, then you can make use of your temporary basal rate and reduce your insulin by around 10-20%, and/or reduce your bolus insulin.
OR, if you are on an insulin pump, you can switch to pens temporarily, so here is some guidance for a short-term switch from an insulin pump to insulin pens for swimming with diabetes.
In this case, you need to give your short-acting insulin every three to four hours. Depending on the “life” of your insulin.
If it literally a case of, you’re at the beach from 9 am until 5 pm, then don’t give yourself any background insulin, this is because these insulins typically last 24 hours, and you will have to wait until that is out of your system before you can safely put your insulin pump on without risking a hypo.
So, to conclude….follow these steps for less than a day of pump removal
Once your day of fun is finished, you can pop your insulin pump back on. Make sure the last bolus of fast acting insulin is out of your body. i.e, wait 3-4 hours from your last bolus before you return the insulin pump to your body.
For more advice on switching from insulin pumps to pens, check out this article.
Whether your insulin pump is waterproof or not is fully dependent on the brand. For example, my old Roche insulin pump was not waterproof, but my new Medtronic insulin pump is!
I’ve done a little research and found what each brand says:
Medtronic: The “MiniMed® Veo™ insulin pump is splash-proof, and therefore we continue to label the MiniMed® Veo™ as water resistant, not waterproof/watertight”
Tandem: The t: slim is not completely waterproof. According to the company, the t: slim has been tested in three feet of water for 30 minutes, which makes it water resistant.
Roche: Accu-chek insight insulin pump is “watertight”, not waterproof.
“IPX8 - protected against the effects of temporary immersion in water under standardized conditions (1.3 m/4.3 ft for 60 minutes)”
Accu-chek combo insulin pump is not waterproof. It needs to be removed for swimming. It can withstand brief accidental water contacts such as rain, water splashes or accidental immersion.
Ominpod: Ypsomed my life OmniPod: 7.6m depth for up to 1 hour (IPX-8)
Just remember, that even if your insulin pump is waterproof, this will only be the case if there are no CRACKS. It’s easy to get tiny cracks and they will no longer be waterproof. So make sure you protect your pump and check for cracks before you swim.
This info is taken directly from the Dexcom website.
“The Dexcom G4 transmitter is not waterproof. However, the Dexcom G4 sensor is water resistant in the shower or bath, or when swimming if the transmitter is fully snapped in. However, the receiver must be kept dry.”
“The Dexcom G5 Mobile System’s transmitter is water resistant. The G5 Sensor Pod is water resistant when the transmitter is installed properly. The receiver is not water resistant or waterproof and can be damaged if moisture gets inside it. Water can also severely limit communication range with the G5, so you never want to prevent communication between the transmitter and display devices.”
The Freestyle libre is what I currently use and I messaged Abbot when I first started using to find out exactly just how waterproof it is (I am a paranoid person!). The main issue isn’t with the Freestyle Libres waterproof state, it’s the fact I always seem to lose them on a water ride, or swimming, or sometimes from sitting in a hot tub. I feel like water makes them very loose, so I would be using tough tape such as those by RockaDex to keep them in place (you get an exclusive discount with them via us!)
But, the Freestyle Libre isn’t waterproof. It’s water-resistant and up to 1 meter (three feet) for around thirty minutes. Abbot has also stated that“intense activities whereby a user is continually moving or repeatedly in and out of the water, may reduce the sensor wear time”.
When you feel dehydrated, it can push up your blood sugars. So, it’s really important to stay hydrated to prevent falling into DKA. Remember that if you are already feeling thirsty, then you are already dehydrated. Sip on water all day, especially if swimming at the beach.
If you are at the beach for a holiday, or simply a day trip, it’s still important to bring spares. The water can rip out pump sites, or CGM sites. I always say bring three times as much, so three pump sites is a good idea if you are on an insulin pump. Don’t forget to put waterproof stickers and rock tapes on your insulin pump sites and CGMs to keep them in place, especially if you are visiting a waterpark with type 1 diabetes.
Also don’t forget to keep your insulin in a cooling case such as Frio, or alternative. If you are swimming in the heat, your insulin will be at risk of dying, but if you keep it in a Frio bag, then it will stay safe whilst you are having fun!
Don't forget to keep your insulin monitors in the shade as extreme heat will stop them from recording your blood sugars, or give you false readings.