Daylight Saving Time presents serious and potentially life-threatening dangers for patients with diabetes who rely on computerized pumps for insulin delivery, according to research published in the Journal of Diabetes Science and Technology.
“Some diabetes patients who use insulin pumps may forget to change the clock that is found in these devices,” Saleh A. Aldasouqi, MD, FACE, of Michigan State University, said in a press release. “Forgetting to change the time can result in insulin dosing errors that can be harmful.”
Saleh A. Aldasouqi
These adverse events can include episodes of hypoglycemia, hyperglycemia or diabetic ketoacidosis. To raise awareness around ensuring internal clocks are set properly at all times, Aldasouqi, along with Amy J. Reed, RD, CDE, of Sparrow Hospital, Lansing, Mich., conducted a review of the literature.
Although the variance with daylight savings time may not significantly impact basal delivery, bolus doses could be significantly affected, according to the researchers; in particular, the insulin-to-carbohydrate ratio may be pronounced if patients fail to change the clock in the spring.
The researchers called a.m.-p.m. clock settings even “more worrisome,” potentially affecting basal rates and bolus doses, and highlighted traveling across time zones as another related issue.
“Because [many] insulin pumps are not GPS-enabled or automatically time-adjusting, extra caution should be practiced by patients to ensure correct time settings at all times,” the researchers wrote. They also addressed the “controversial” nature of GPS technology, in which clocks are changed automatically based on location, due to privacy concerns, according to the release.
Aldasouqi noted he has seen patients come into his office who have forgotten the time change or never adjusted the clock after changing the pump battery; the researchers called for clinicians’ assistance in preventing this problem.
“Clinicians and diabetes educators should verify the date/time of insulin pumps during patients’ visits, and should remind their patients to always verify these settings,” the researchers wrote.
Disclosure: Aldasouqi receives speaking honoraria from Janssen, Sanofi and Takeda.