Insulin Pump Removal Required for MRI Scans
No, you cannot wear an ambulatory insulin pump during an MRI scan—the pump and metal infusion set must be removed before the procedure. 1
Clear Directive from Guidelines
Multiple professional society guidelines explicitly state that insulin pumps must be removed for MRI procedures due to concerns about electromagnetic field interference and potential pump malfunction. 1
- The British Journal of Anaesthesia guidelines (2016) unequivocally state that for CT/MRI procedures, the pump and metal infusion set must be removed. 1
- The Lancet Diabetes and Endocrinology (2021) reinforces that pumps must be removed for certain radiological procedures including MRI. 1
- All insulin pump manufacturers recommend against exposure to MRI screening procedures according to published perioperative management guidelines. 1
Critical Safety Rationale
The electromagnetic fields generated during MRI can cause:
- Insulin pump malfunction or failure 1
- Unpredictable insulin delivery (either excessive or interrupted) 1
- Potential heating of metal components in the infusion set 1
The infusion set cannula can remain in place, but the pump itself must be physically disconnected and removed from the MRI suite. 1
Management Protocol for MRI Procedures
Before MRI:
- Start intravenous insulin infusion at least 30 minutes before disconnecting the pump, initially at the patient's programmed hourly basal rate. 1
- This overlap prevents rapid hyperglycemia and ketosis, which can develop within 1 hour of pump disconnection. 1, 2
- Monitor blood glucose hourly during the transition. 1
During MRI:
- The pump remains outside the MRI room entirely. 1
- Continue IV insulin infusion, adjusting based on blood glucose monitoring. 1
- The subcutaneous infusion cannula can stay in place if needed. 1
After MRI:
- Reconnect the pump and run it alongside IV insulin for 2 hours to re-establish a subcutaneous insulin depot. 1
- Monitor blood glucose hourly during this transition period. 1
- Discontinue IV insulin only after confirming adequate subcutaneous insulin delivery. 1
Important Caveats
For emergency MRI situations where 30-minute overlap isn't feasible, start IV insulin immediately upon pump removal without delay. 1 The risk of diabetic ketoacidosis from insulin deficiency outweighs concerns about brief hyperglycemia.
Continuous glucose monitors (CGMs) should also be removed for MRI, though some newer evidence suggests certain CGM sensors may be safe during imaging—this remains manufacturer-specific and requires verification. 1, 3 When in doubt, remove all diabetes technology devices.
Alternative approach for very short MRI procedures: If the MRI will be completed in under 1 hour and the patient has good baseline glucose control, some centers may opt for close glucose monitoring without IV insulin, but this requires explicit institutional protocols and is not the standard recommendation. 1
The bottom line: pump removal is mandatory for MRI safety, and proper insulin replacement via IV infusion is essential to prevent life-threatening hyperglycemia and ketoacidosis. 1