Excercising on pump

Diabetes Technology Insulin Pumps
1

I just started pumping a week and a half ago. For the past two days, I have gone on brisk walks for about 30 minutes, have had some active insulin on board (minimal) from lunch, but sat at 120 prior to exercising. Both days I have dropped to the 50's -yesterday I halfed the basal rate (which is tiny in the afternoon), and temp basal at 0% for 1 hr after due to the low (and shot up to 160 after the hour with a 15g carb treatment), and today was 58 after - but I temp basal 0% for 1/2 hour prior to the walk , during the walk and 1 hr after the walk. Just curious to see how you all handle exercise on the pump. I guess I wil find out what works with more experimentation.

2

Hi Jennifer-

Many people find that late afternoon is a difficult time to adjust insulin/basal settings for exercise. I’m guessing this is also an issue for Lantus/Levimir users (perhaps you had some issues too with afternoon exercise prior to pumping?) I don’t exercise much in the afternoon, but when I do, I too have issues.

I find that when I jog for about 1/2 hr. I have greater insulin needs that when I walk. I’m guessing that adrenaline plays more into the running/jogging than the walking because I too drop low and drop fast when walking. I would suggest maybe decreasing your bolus for lunchtime. And maybe you are best to start out at 160 mg/dL or even higher when you walk. Yes, play with temp basal, but if that seems to still not be working and getting you where you’d like to be, perhaps fuss with the bolus.

Best of luck! Keep experimenting and carry that meter and quick sugar!

~a.willie

3

That is a good idea -maybe only cover half the carbs for lunch. Thanks for your input.

4

I can never exercise on a bolus

5

I never exercise within 3 hours of a bolus or I’ll be laying on the ground. I always cut my basal by 50% starting about 30 minutes before I start. Works well for me, but we’re all different.

6

I’m curious to know what your BG was a couple hours after the second walk. I’m betting it shot up.

Here’s some thoughts:

  1. Set the temp basal 1 to 2 hours before exercising. 1/2 hour is too close given that your insulin has a 1-2 hour peak. In short, you are not getting the effects of the reduced basal DURING your exercise, but 1/2 to 1.5 hours AFTER your exercise.

  2. Don’t reduce your basal to 0%. It’s the same as a non-diabetic turning off their pancreas, and nobody does that. The effect is to have NO insulin 1-2 hours after you’ve set the basal. This can easily lead to DKA (voice of experience here). Instead, set it to 50% or some number higher than 0%.

  3. Get a copy of “The Diabetic Athlete” by Sheri Colberg. In the meantime, here’s an article by her about exercising with the pump.

  4. If you continue to drop low after starting at 120 and exercising for 30 minutes, eats some carbs first - an apple or half a PB sandwich or something. John Walsh, author of “Pumping Insulin” (another book I recommend for all pumpers) talks about the concept of “ExCarbs” (short for exercise carbs-carbs ingested specifically to cover exercise) in that book and in this article.

Good luck,

Terry

7

THanks you all for your input.

Hi Terry - Thank you VERY MUCH for your input. I am a T2, so I still make some insulin. BG after todays walk and 8 carbs to correct the 58 was 97 (I made sure I didn’t overtreat the low today). Pre dinner, a couple hours after basal resumed was around 100.