Full-body x-ray scanners and luggage x-rays may damage some insulin pumps and continuous glucose monitors, both used by people with diabetes to manage their conditions.
It's likely that every day, large numbers of travellers expose these diabetes care devices to x-rays while going through airport security, "and some may unknowingly experience mild (or worse) malfunctioning as a result", say the authors of a recent editorial in the journal Diabetes Technology & Therapeutics.
They recommend carrying a letter that details all of the medical supplies people with diabetes need to carry on board with them. They also recommend that if they wear an insulin pump or continuous glucose monitor, the letter specifically states that these devices should not be subjected to x-rays, either from a full body scanner or the x-ray machine that scans carry-on luggage.
Instead, these devices should be hand-checked, according to editorial co-authors Andrew Cornish and Dr Peter Chase, from the University of Colorado Denver.
Dr Tracy Breen, director of diabetes care for North Shore-LIJ Health System in New Hyde Park, New York, agrees with this advice.
"I always recommend that people living with diabetes travel with a letter from their doctor stating their diagnosis of diabetes, what their travel needs are and what supplies they are traveling with.
"Since we really don't know what can happen to an insulin pump when it is passed through an imaging device, it is important to follow the manufacturer's recommendations." Breen says. "It's also important for people and their doctors to be well versed in (travel) guidelines and to consider incorporating those guidelines into the text of their travel letter."
The editorial describes the experience of a 16-year-old patient who was told to wear her insulin pump through a full-body scanner. As a result of the x-ray exposure, the pump's manufacturer advised the girl to disconnect the pump, as they couldn't be sure whether or not damage had occurred. Any pump that uses direct current motor technology is at risk from x-ray exposure, say the researchers.
Insulin pumps made by US companies such as Medtronic, Animas and Tandem Diabetes Care use direct current motor technology.
"We recommend the t:slim pump (the first insulin pump with a touch screen) be removed when entering a full body scanner," says Susan Morrison, director of corporate investor relations at Tandem in San Diego.
Tandem also recommends that the t:slim pump not be exposed to luggage X-ray machines.
Currently, the only insulin pump approved by the US's Food and Drug Administration, that does not use direct current motor technology is the OmniPod by Insulet.
That pump uses shape-memory alloy wire technology, which according to the company, isn't affected by X-ray exposure. Insulet's user manual says that both the pods, which hold insulin and are attached to the body, and the wireless device that controls the insulin delivery can be X-rayed.
Medtronic also cautions against allowing its continuous glucose monitoring device to go through any type of X-ray. None of the pump companies expressed concerns about passing these devices through the metal detectors at airports.
The editorial notes that on an airplane, the increased pressure in the cabin can cause some insulin pumps to deliver slightly more insulin. In general, this isn't a significant concern for teens or adults because the potential amount of extra insulin isn't large enough to make a big difference in blood sugar levels. In children who use very small amounts of insulin, the extra insulin could cause a drop in blood sugar levels.
Parents who are aware of this danger can monitor their children more carefully while flying to avoid unexpectedly low blood sugar levels. The sensitivity of continuous glucose monitors may be affected by changes in air cabin pressure, with extra pressure possibly causing lower readings.
The authors of the editorial say that more research is needed to determine exactly how much insulin delivery and continuous glucose monitor readings are affected by air cabin pressure.
Source: HealthDay News, Business Day via I-Net Bridge
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