BLOG: Bills to end daylight saving time change could end insulin pump glitch
This Sunday, Nov. 1, will mark the end of daylight saving time for 2020.
I am pleased to share that, finally, serious legislative considerations — in several states — are underway in the quest to end the biannual rituals of changing from standard time to daylight saving time (DST).
During the last 3 years, 13 states enacted legislation to provide for year-round daylight saving time if Congress were to allow such a change and, in some cases, if surrounding states would enact the same legislation, according to the website of the National Conference of State Legislatures. Full-time DST is not currently allowed by federal law and would require an act of Congress to make a change.
Those 13 states are Florida and California (2018); Arkansas, Delaware, Maine, Oregon, Tennessee and Washington (2019); and Georgia, Idaho, Louisiana, South Carolina, Utah and Wyoming (2020).
Since this blog launched in November 2016, I have posted twice-a-year reminders for patients prescribed insulin pump therapy and their clinicians and caregivers to pay attention to the DST changes occurring in March and November.
In most posts, I reference the review article that my colleague and I published in the Journal of Diabetes Science and Technology (Aldasouqi SA; Reed A. 2014; doi:10.1177/1932296814541811). That article detailed the risks of potential errors in insulin doses if users forget to make the time changes in their pumps. In these posts, I emphasized the potential risk of hyperglycemia or hypoglycemia resulting from such dosing errors. I also stated examples of cases that we encountered or heard of, where such errors resulted in hypoglycemia. In addition, I also elaborated on the health risks resulting from the spring DST change, including traffic accidents and heart attacks, due to the loss of 1 hour of sleep and sudden changes in circadian rhythm.
Insulin pumps are not equipped with built-in mechanisms to adjust the internal clocks to the DST changes; the rapid advancements in technology over the last few years, such as the advance of hybrid closed-loop insulin delivery systems, may ultimately solve this limitation; however, the majority of insulin pumps currently in use still have the old systems, which need manual adjustment by patients.
The movement toward eliminating the DST change has grown stronger around the country. Currently, only Hawaii and Arizona (except for the Navajo Nation) and a few U.S. territories do not change their clocks twice a year.
Staying on DST permanently will certainly eliminate many of the problems stemming from time changes. However, there is a caveat herein. The problem with maintaining DST yearlong would mean that the mornings in the winter will be too dark for students to wait for school busses outside. That can be dangerous. This happened in 1974; the government enforced a permanent DST change in January 1974 following the 1973 oil crisis, and it was intended to keep DST for 16 months. By fall, it was reported that it was too difficult and dangerous for students.
Apart from these legislative discussions, and since we still have the DST changes occurring across most of the country, I wish to send a renewed precautionary note to everyone using insulin pumps to remember to adjust the time of their insulin pump for the DST change this coming weekend.