An insulin pump allows the replacement of slow-acting insulin for basal needs with a continuous infusion of rapid-acting insulin. By using an insulin pump, the patient can typically match the dosage of insulin to lifestyle and activities, rather than adjusting those to the body’s response to insulin injections. The advantages of using an insulin pump include the fact that it replaces the need for periodic injections by delivering rapid-acting insulin continuously throughout the day via a catheter, which greatly simplifies the management of diabetes.

There are two basic types of insulin pumps, one is used as an external device and the other is implanted. Both types currently pose hazards to patients referred to MRI procedures. For an external insulin pump, in general, the device typically needs to be removed and kept out of the MRI environment to ensure that there is no adverse impact on the functionality of the external pump. The information below provides examples of MRI information for several, commonly used insulin pumps.

Insulin Pumps, Animas Corporation

This MRI information pertains to the following insulin pumps from the Animas Corporation:

• Animas 2020 Insulin Pump
• IR Animas 1200
• IR 1000 Insulin Pump
• IR 1100 Insulin Pump
• IR 1200 Insulin Pump
• OneTouch Ping Insulin Pump

Each insulin pump indicated above should not be exposed to very strong electromagnetic fields, such as MRIs, RF welders, or magnets used to pick up automobiles. Very strong magnetic fields, such as that associated with MRI, can “magnetize” the portion of the insulin pump’s motor that regulates insulin delivery and, thus, damage the device.

For the patient: If you plan to undergo an MRI, remove the insulin pump beforehand and keep it outside of the MR system room during the procedure.

If the pump is accidentally allowed into the MR system room, disconnect the pump immediately and contact Animas Pump Support for important instructions.

Precautions: If you are going to have diagnostic or surgical procedures that expose you to X-ray, CT scan, MRI or any other type of radiation therapy, you may need to remove your insulin pump (and meter-remote), and place them outside of the treatment area. For specific procedure information please refer to the instructions for use that accompanied your insulin pump. Consult your healthcare professional for direction in maintaining your blood glucose levels during these type of procedures.

For the Healthcare Professional: Do not bring the insulin pump into the MR system at any time. If the pump is accidentally allowed into the MR system room, disconnect the pump immediately and contact Animas Pump Support for important instructions.

Cozmo Pump, Infusion Pump, Smiths Medical

According to the User Manual for the Cozmo Pump which is a device used to administer insulin, the following is stated regarding MRI:

Caution: Avoid strong electromagnetic fields, like those present with Magnetic Resonance Imaging (MRI) and direct x-ray, as they can affect how the pump works. If you cannot avoid them, you must take the pump off.

Medtronic MiniMed 2007 Implantable Insulin Pump System, Medtronic, Inc.

The Medtronic 2007 Implantable Insulin Pump System may offer treatment advantages for diabetes patients who have difficulty maintaining consistent glycemic control. Patients that have not responded well to intensive insulin therapy, including multiple daily insulin injections or continuous subcutaneous insulin infusion using an external pump, may be primary candidates for the Medtronic MiniMed 2007 System. The Medtronic MiniMed 2007 System delivers insulin into the peritoneal cavity in short, frequent bursts or “pulses”, similar to how pancreatic beta cells secrete insulin.

The Medtronic MiniMed 2007 Implantable Insulin Pump is designed to withstand common electrostatic and electromagnetic interference but must be removed prior to undergoing an MR procedure. Any magnetic field exceeding 600 gauss will interfere with the proper functioning of the pump for as long as the pump remains in that field. Fields much higher than that, such as those emitted by an MR system, may cause irreparable damage to the pump.

By comparison, infusion sets (MMT-11X, MMT-31X, MMT-32X, MMT-37X, MMT-39X) used with this device contain no metallic components and are safe to be used and can remain attached to the patient during an MR procedure. The only exceptions would be Polyfin infusion sets. Polyfin infusion sets (MMT-106 AND MMT-107, MMT-16X, MMT-30X, MMT-36X) have a surgical steel needle that remains in the subcutaneous tissue. These infusion sets should be removed prior to any MR procedure.

MiniMed Paradigm REAL-Time Insulin Pump and Continuous Glucose Monitoring System (Models 522, 722 and Revel Insulin Pumps), Medtronic, Inc.

MRI Information for Patients and Magnetic Fields

Do not use pump cases that have a magnetic clasp.

Do not expose your insulin pump to MRI equipment or other devices that generate very strong magnetic fields.

The magnetic fields in the immediate vicinity of these devices can damage the part of the pump’s motor that regulates insulin delivery, possibly resulting in over-delivery and severe hypoglycemia.

Your pump must be removed and kept outside the room during magnetic resonance imaging (MRI) procedures.

If your pump is inadvertently exposed to a strong magnetic field, discontinue use and contact your local help line or representative for further assistance.

The insulin pump, transmitter, and sensor must be removed prior to entering the MRI environment.

MiniMed 530G System, Medtronic, Inc.

The MiniMed 530G system is intended for continuous delivery of basal insulin (at user selectable rates) and administration of insulin boluses (in user selectable amounts) for the management of diabetes mellitus in persons, sixteen years of age and older, requiring insulin as well as for the continuous monitoring and trending of glucose levels in the fluid under the skin. The MiniMed 530G system can be programmed to automatically suspend delivery of insulin for up to two hours when the sensor glucose value falls below a predefined threshold value.

MRI Information for the Patient

Exposure to magnetic fields and radiation. If you are going to have an X-ray, MRI, diathermy treatment, CT scan, or other type of exposure to radiation, take off your pump, sensor, transmitter, meter and remote control before entering a room containing any of these equipment. The magnetic fields and radiation in the immediate vicinity of these devices can make them nonfunctional or damage the part of the pump that regulates insulin delivery, possibly resulting in over delivery and severe hypoglycemia. If your pump is inadvertently exposed to a magnetic field, discontinue use and contact our 24 Hour HelpLine for further assistance.

DANA Diabecare IIS Insulin Pump and DANA Diabecare Insulin Infusion Pump (SOOIL Development Co., Ltd.)

The pump must not be used in the presence of intense electromagnetic fields, such as those generated by certain electrically powered medical devices. The pump should be removed prior to the user having a CT Scan, MRI or X-ray.

t:slim Insulin Pump, Tandem Diabetes Care, Inc. MRI Information for the Patient: Radiology and Medical Procedures

If you are going to have an X-ray, computerized tomography (CAT) scan, magnetic resonance imaging (MRI), or other exposure to radiation, take off your t:slim Insulin Pump and remove it from the procedure room. If you have questions, contact Tandem Diabetes Care Customer Technical Support at 1-877-801-6901.

ACCU-CHEK Insulin Pump, All Models, Roche Diagnostics MRI Information for the Patient: Do not use your pump around electromagnetic fields such as radar or antenna installations, high-voltage sources, X-Ray sources, MRI, CAT scan, and all other sources of electrical current as they may cause your pump not to work. Insulin delivery may stop and an error E7: ELECTRONIC ERROR may occur. Always stop and remove your pump before you enter these areas.

OmniPod Insulin Management System, Insulin Pump, Insulet Corporation

Controlling device must be removed before entering the MR system room.

MRI healthcare professionals are advised to contact the respective manufacturer in order to obtain the latest safety information to ensure patient safety relative to the use of an MR procedure.

REFERENCES

www.accu-chek.com

www.animascorp.com

www.medtronicdiabetes.com

www.myomnipod.com

www.smiths-medical.com

www.sooilusa.com

www.tandemdiabetes.com