Controlling BG after hard work-out in evening in 12 yr old

Diabetes Technology Insulin Pumps
#1

Hi All,

My 12 year old has begun swim team practices again and he exercises incredibly hard for an hour or more each evening, finishing at 8pm. He goes to bed at 9pm and at that time his BG is usually between 120-150 with no IOB. However, we are finding that his BG is continuing to drop dramatically overnight to the 70's by 1am. Last night he needed 30g CHO to get him above 120 and he was still only 125 at 7am. He only attends swim practices 3-4 times a week and so making a global change to his basal rate would not be preferred. Would it be better to give him a snack right before practice or right after and then not bolus? We already only bolus him for about 75% of his CHO at dinner time and then suspend his basal for one hour while he works out. However, the way I see it, we should probably make sure his BG is closer to 150-175 at bedtime on the days when he has been working out hard. Any thoughts? We have an appointment with his endo next week so can probably figure things out then but he has 4 more practices before then.

Thanks!

#2

Hey there,

I have a few suggestions. First, I would look into adjusting his basal rate using temp basals during the times when he is exercising and for a few hours after. Since you seem to be seeing a pattern of him dropping after the swim practice, I'd start with a 10-15% reduction in basal rate for 4-5 hours after he is done with the swim practice. So, you'd be suspending the basal during practice (which I think is wise), and then when he's finished with practice, enter in a temp basal decrease of 10-15%.

The second suggestion would be to have some sort of low carb, high-protein and/or fat food after practice (but not too much!). Probably 1 oz of almonds or something like that. A snack like that usually does a good job of levelling out my blood sugar if I think it is going to be dropping, since the carbs will take a longer time to absorb.

I hope this works for you!! I'd also say that starting practice with a bit of an elevated BG reading probably isn't a bad idea, but it can be difficult because you don't want him to be too high. Also, a morning BG of 125 is excellent!

Anyway, good luck. Getting used to an exercise routine is always tough. I should also mention that it's been a while since I was 12 years old, but I think these suggestions are largely universal.

#3

These are great suggestions - thank you. I think it's going to take some time to figure out what works best for him but we'll try tonight and see how things go.

#4

No problem. I hope it works out for you!

#5

It seems that you have his BG under good control before he gets to sleep. And I agree with markeeezy that a fasting BG of 125 is great. So I would just let him have a 30g CHO snack before bedtime and see how that works for him.

#6

i agree with markeeezy. i usually eat high protein bar before workout as i had the same issue.

other than that, he should take regular Gatorade after workout. this will help him regulate glucose and energy level after his swimming.

#7

agree with above. My daughter usually has to be at least 150 before she starts intense exercise and stay on temp basal -25% for at least 4 to 5 hours after sometimes longer , otherwise she wakes me up at like 2am with a BG of 50.

#8

We have not tried an extended temp basal but this sounds like a good way to ensure he does not drop down during the night, especially since he does not finish exercising until 8pm. Thanks!

#9

I turn to peanut butter as a bedtime snack or something with beans (chili/baked beans/soup)for dinner if I want to keep my blood sugar steadily up - but without a spike. I would create a basal program for those days. It will beep on suspend or temp mode.

#10

I tried a combination of the various suggestions yesterday and it worked pretty good. Sam bolused for only 75% of carbs at dinner time and I also gave him a big spoonful of peanut butter. I then reduced his basal by 25% for 2 hours starting at 7pm. At bedtime he was 278 and I had to REALLY resist the urge to make a correction but at 7am this morning, he was 151. We're certainly getting on the right track! Thanks everyone for your suggestions.

#11

It only beeps if you have certain settings enabled. I'm not sure which ones specifically, but I have all "reminders" set to "Off" in my "Alerts/reminders" section, and it hardly ever beeps at me. I prefer it that way.

Just so you know!

#12

Good for you! It's definitely always an adjustment getting used to an exercise routine, and you'll have to tweak til you get it right. Eventually you want to get it to the point where you don't have to run him so high, but I'm sure you know that.

#13

Thanks Markeeezy! I took a look at my Alerts/reminders. I have all off except for 'confidence reminder' The manual says that it controls:

  • Bolus delivery started.
  • Bolus delivery completed.
  • Extended bolus started.
  • Extended bolus completed.
  • Temporary basal rate started.
  • Temporary basal completed.

I like the setting to hear the bolus delivery started and completed, but it seems like I could re-set it to off if I want to go to bed with a temporary basal and don't want to hear the beeps.

Thanks!
#14

You're very welcome! Glad that helped.

I would actually like to be able to separate those, cause I wouldn't mind hearing the bolus confirmations. I just can't stand the temp basal beeps cause I run temps pretty frequently (exercise, etc.)

Also, though, I can usually hear when the *clicking* stops haha