Our daughter Cass is Type 1 diabetic and one of her first questions when she realised that her insulin pump need to be attached to her 24 hours a day, was “What about swimming?”. The most recent generation of pumps are (mainly) waterproof in pristine condition. One micro-crack inside and water will leak in. Additionally, the waterproofing built in is for fresh water only – if you are at the beach with salt water you have no real protection. For a quick dip in the local pool, disconnecting the pump is standard procedure, but what about water sports, spending a day at a water park or the beach?
We asked around and Aquapac is the name that kept coming up when people talk about protective waterproof cases. Most Aquapac cases seal completely, but they make three cases that are a little different. Instead of a watertight seal, these cases have a tiny opening which the cannula cable can go through – the pump stays dry inside the case and you can stay connected. We reached out to Aquapac and they were good enough to let us experiment with two of their models – the ‘insulin pump case’ and the ‘waterproof case for wire-out electronics – large’.
Retailer: Aquapac +
Price: ± £40 for the smaller and £45 for the larger case.
I would consider also sourcing an elastic belt particularly for a much younger or smaller user.
Aquapac is the first name that comes to most peoples mind when it comes to waterproofing electronics. They’ve been running for 30 years and were the first to provide waterproof cases for the first Motorola Startac phone and have expanded into everything – camera cases, dry bags, radio mic bags and insulin pump cases.
Insulin pumps come in multiple shapes and sizes and our first question was: Do they fit?
In the UK there are 10 different pumps available on the NHS. Exclude the pod design pumps like the Omnipod that wouldn’t fit in a case and eight remain. Exclude those that are specifically not waterproof at all and you’re left with six. Of those all fit into the larger of the two cases and three fit into the smaller case. Cass’s pump is the Medtronic Minimed 640G which just fits in the smaller case and fits easily in the larger.
The smaller case has a single opening where the pump slides in and the tubing comes out, adding the small bonus of not having to disconnect to put the pump in the pouch. The larger case has two openings – one to fit the pump in and one to snake the tube out of – which requires a disconnect. The closure mechanism on both is well designed and impressively engineered, but needs to be lined up perfectly and takes a fair amount of pressure to close. Cass wasn’t able to apply enough force to do it herself, but I had no problems once I’d gotten it lined up.
Both cases have a long loop on the back with a width of 7cm that is designed to have a webbing belt looped through it. The belt (which is completely removable) was sized to work for a larger adult and while it cinches down gave Cass a long tail the first time she took it into the water. I was able to trim it down to a more manageable length and the second time in went better. The larger case also comes with a removable lanyard that lets you hang it around your neck.
How was it in the water? The waterproof seal held perfectly and the pump stayed bone dry in its own little air bubble in all our testing.
Lets talk about flow and insulin. To get a watertight seal around the tube the case has to grip it tightly. The pipe is only made of a thin plastic and can be squashed slightly and that reduces the flow. Aquapac have had this tested and the short version is that if you’re on a low basal, you might get reduced levels of insulin. Higher flows did not seem as affected and I’d expect that bolusing for meals would not be either. We had no need to adjust her basal insulin – the combination of increased activity levels reduced her insulin requirements so that the normal amount worked out very well – we even had to suspend regularly.
The very nature of swimming – particularly in warmer pools or on bright sunny days – also has potential dangers for insulin denaturing. It should be reasonably protected inside your pump (unless you go in a Sauna or jacuzzi!), but in your tube would be less so. It is not a detraction, just be aware that the Aquapac offers no temperature insulation.
The pump was useable through the case with the buttons pressable and the screen clearly readable. Cass’s pump has an integrated CGM that uses radio to connect to her sensor. This worked perfectly through the case, but unsurprisingly when she was in the water the radio was blocked and it stopped working.
The case is suspended from the belt and when underwater, it tried to float up, which she didn’t find comfortable. It was fine for watersports and playing in shallower waves, to the point where she forgot it was there. She doesn’t need her pump when swimming and CGMs do not work in deep water anyway, so we’re happy to just disconnect for it, but it’s the water-based activities that often stretches over many hours that’s the headache. The Aquapac added a lot of conveniences – it covered the periods of inactivity, provided access to her CGM data and she could snack, move and take breaks without worrying about her glucose levels all day long.
The belt isn’t elastic and getting the balance right between being tight enough to hold the pump in place without discomfort was difficult. Wearing a tankini or rash vest was the best solution – it provided excellent access for tubing whilst adding a layer of protection between her and the case.
Environment & People
Insulin pumps are the ultimate in personal devices. They cost anywhere from £1000 to £4000 and are literally attached to you for anywhere from two to four years for virtually 24 hours a day. Many are at least water resistant, but particularly with cracks or damage from drops, this isn’t protection that can be relied on. A £40 case to keep it safe in or near the water is excellent value for money.
Aquapac is a highly reputable brand that have tested and manufactured their cases to the highest quality standards. Aquapac also provide a five year guarantee for all cases. £40 for an Aquapac case is a bargain.
Insulin Pump Case
Dimensions: 23 x 8cm
Maximum pump size: 16cm diameter and 15cm length
IPX Rating: IPX6
Materials: UV resistant TPU plastic
Weight (case): 47g
Weight (belt): 59g
Waterproof case for wire-out electronics
Dimensions: 11.5 x 22cm
Maximum pump size: 25cm diameter and 22.5cm length
IPX Rating: IPX6
Materials: UV resistant TPU plastic
Weight (case): 87g
Weight (belt): 59g
Clamp size for up to 2.5mm wire or tube
Made in the UK.
Warranty: 30 day no quibble return and five years free from defect.
Aquapac cases are very, very well made. We didn’t get a single leak or drop of water inside them at any point in our testing. There is no guarantees that pumps will stay dry and insulin tubing will always work perfectly through the seal, but we felt highly confident that the level of water that might get in wouldn’t be a problem for most modern pumps and didn’t experience any insulin flow issues.
In fact, it cut down on swimming-related insulin flow issues as we didn’t have to disconnect (after a disconnect Cass’ levels take up to an hour to return to normal during which time she can’t eat we often see a significant rise). They are so well made I might call them over-engineered – the clasp takes a fair amount of pressure to close properly and you can see why they’ll guarantee it for five years.
For a swim session at the local pool, Aquapac is superfluous. Pump users can disconnect for up to an hour and high-intensity exercise like swimming heavily reduces insulin requirements during that time so there is no need to remain connected to your pump – and the CGM wouldn’t work either anyway.
Aquapac cases are ideal for long swim sessions, watersports, waterparks and beach activities. If you’re planning a beach holiday, swimming for several hours somewhere like Centre Parcs or are interested in watersports, it’s a must-have item. I’d base my choice of which of the two cases on the size of your pump – if you can get your pump in the smaller case go for that one – you don’t have to disconnect and it has a smaller air bubble to contend with in case you always want to go for a swim without stopping to remove it.
Cass’ response to the Aquapac was overwhelmingly positive – she instantly envisioned jumping off the back of a Catamaran into the ocean (her all-time favourite holiday experience pre-diabetes), learning how to surf once she’s finished learning how to swim and spend an afternoon researching kayaking, windsurfing, SUPs, jet-skiing and white water rafting, highly pleased that these are potential future activities that she would now be able to do later in life without a worry.
Highly recommended for pump users who are also enthusiastic swimmers or do water sports.
The review is based on the Aquapac Insulin Pump Case and Waterproof case for wire-out electronics kindly provided by Aquapac during January 2017. This article was first published on the 1 February 2017.