While this blog is about humanities in medicine, I have decided to dedicate some posts for public education. The purpose of this post is to remind patients with diabetes, their caregivers and all health care providers taking care of patients with diabetes about the glitch in insulin pumps’ internal clocks. The clocks do not adjust automatically during daylight saving time changes or when traveling across time zones. Patients themselves or their caregivers in the case of children pump users should manually adjust the insulin pump clocks.
Furthermore, patients using insulin pumps or their caregivers should manually adjust the insulin pump clocks upon first use, whenever they change the batteries and whenever rebooting the pump.
The scientific explanation of this glitch is fully elucidated in my blog post from the spring daylight saving time change posted in March 2017.
In a nutshell, unlike cellphones and similar electronic gadgets, most commercially available insulin pumps are not GPS-enabled or wirelessly connected to the internet. The reason for this is not fully understood. From personal discussions with some engineers/experts at a pump manufacturer, a plausible reason is related to concerns about hacking and privacy.
To reiterate the prior discussions detailed in previous publications, to ensure proper function of insulin pumps, the internal time/date settings should be the same as the real time/date. Insulin pumps deliver insulin around the clock in variable basal rates. Further, premeal insulin doses depend on the content of food (meals/snacks have various amounts of carbohydrates) and the time of day/night (varying levels of physical activity). These are all important factors determining the insulin doses hence, the importance of synchronized time/date settings.
Incorrect time settings may result in incorrect insulin doses. Both over dosing or under dosing of insulin may be potentially harmful causing hypoglycemia or hyperglycemia.
The impetus for republishing this reminder is because there is not enough awareness about this important issue among patients, caregivers, health care providers, health organizations and the general public. People have difficult remembering to reset clocks and watches.
The next daylight saving time change is coming, Sunday, November 5.
To all patients using insulin pumps or their caregivers, please remember to reset the time on your device and to all health care providers, please notify your patients with diabetes who use an insulin pump to reset their pump clocks.