Exercise with insulin pump and CGMS?

I agree with my endo. I need to lose some weight but mostly I just need to get the blood pumping. My sister-in-law wants me to join her and her husband to to the The MAX Challenge, a high-energy workout that lasts about 45 minutes.

I visited the local MAX and watched one of the session and I have a lot of concerns. With the jumping jacks and the other aggressive movements and loud music what do I do with my CGMS receiver? Where can I put it so that I can both see and hear it? How do I prevent sweat from weakening the adhesive and the sensor coming off? Same question about the adhesive for the infusion site.

I know that adjusting my basal insulin may be necessary but by how much? I know that trial and error is involved but I am concerned about the error part. I have hypoglycemic unawareness (hence the need for the CGMS) and there is nothing worse than a hypo to make muscles feel useless.

I don’t do really excessive activity in my workouts, but I do move a lot and do some hopping (I’m not in good enough shape to outright jump). It all jostles my pump a lot and gets me sweating. I simply keep my pump clipped on my hip where I always have it and don’t have problems with it getting knocked or bounced off. If you are concerned about hearing it, I might suggest clipping it to your shirt collar where it is close to your head. There is a cool website that sells tanks with pockets that zip made especially for pumps and CGM receivers (www.rylespocket.com).

I rarely have trouble with adhesive sticking with my CGM or pump. Never has it been affected by sweat. I just clean the skin with alcohol before inserting new sensors or cannula’s and the alcohol drys the skin enough to let the adhesive stick real good. On the rare occasion where the adhesive wants to come up, I just use medical tape to hold it down.

For at least a year I had hypo unawareness. My CGM has been a life saver!

Good luck to you. :smile:

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Thanks for posting @Tamra11. The Ryles Pocket web site is interesting but … I’m not sure tank tops are my style (and it’s winter here). :smile:

I did some research over the weekend and got some suggestions from family.

The advice that I have read suggest taking the pump off. Intense exercise can lower BG very quickly. Removing the pump to mitigate damage and also stop the insulin flow seems like a good idea.

I have SPIBelt to hold the pump in place when I sleep. SPIBelt make a SPIBand that I could use to hold the CGMS in place. The 6" version might fit my wrist and the reviews are positive. I’ll order that and see how it goes. I still don’t know if the CGMS alarm can be heard above the music.

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I’ve done T25 and P90X3 that might be similar to the Max program. They are fun!! I’m not a “dealer” though!!

I clipped my Medtronic pump to my shorts and it was fine. I found that the lifting/ anaerobic workouts would push my BG up, rather than down, 50+ mg/ dl when I’d “go for it” and toss another 5 lbs on. The workouts I did tended to combine some anaerobic with some cardio and some yoga/ pilates mixed in to boot. The videos had a schedule so I could anticipate a day that would be more cardio than lifting but a CGM makes it much easier.

It looks as if everybody in the Max video has a “space” so you could probably just put your Dex next to you? I had an Amphipod belt for running that would easily hold a Dex receiver in a pocket, handy but out of the way. It’s similar to a Spibelt.

re the taking the pump off. I also have run quite a bit (although not as much recently, I was very lazy this winter…), 2x marathons and 9 1/2s. When I started, I assumed that my BG would go down running however when I started running with a group, they made nutrition/ fuel a part of the training programs, having some sort of carbs to balance the demands of the long training runs. I eventually figured that 8-15G of carbs would cover 3-5 miles (this at 9-11 minutes/ mile…) and I just used Gatorade to cover that on most of the long runs, using the powder and making it stronger for longer runs, we’d hit drinking fountains or water jug the group put out to support the runs. One of my long runs was in NYC and It was supposed to be 16 but I got a bit lost and ran an extra mile or so after I ended up on 110th St. meandering through Central park. Fortunately, there are plenty of provisions as I brought some money in case I’d needed to cab it back!!

@Khurt_Williams I use a flipbelt https://flipbelt.com/. It is stretchy enough that I can fit my medtronic pump AND my iphone 6 plus inside. So I don’t see any reason why a Dex receiver wouldn’t fit in there.

I’m dealing with a roller coaster right now when it comes to exercise. I walk for 40 minutes and stay in a nice pretty range, then I work on the machines and manage to spike up. I’ve been playing with basals for a few days now to no avail.

Sigh, another thing to deal with.

Sarah :four_leaf_clover:

If you are asking for suggestions on how to manage your kit then I assume you haven’t been doing “high-energy workouts” on a regular basis or even on an irregular basis. So aside from the gear I would suggest you work your way up to joining in.

Going from zero to one hundred sixty in terms of workout intensity with no prep will result in a lot of muscle pain and possibly worse. Better to take it in steps to allow your body a chance to become acclimated.

The (somewhat) slower approach bundles in the advantage of letting you get a feel for how your body & insulin will respond to the extra activity and how best to handle it. This is something I personally would rather rehearse in a less public setting.


I play soccer 2-3 times a week and have only ever had problems with the infusion site sticking maybe twice. Both those times, I was on the last day of the site so it was going to come out soon anyway. I have had the pump ripped out many times but that has more to do with the contact in the sport than the exercise. As for whether to remove it or not, I usually base that on where my BG is before playing. You’re going to have to experiment with that. About half the time I remove it and keep it nearby so I can take a small bolus if needed, other times I just set a temp basal of like 30-50%. I did crossfit for about a year on the pump and never had any issues but like someone above said, ease into it or you could be setting yourself up for injury.

Is there some sort of formula to use to get a starting point? The advice I have found said to experiment, but … experiments sometimes don’t go as planned. How does one plan for when things go wrong and one is the ONLY person in the gym(or in the park etc. ) who really understands what’s happening and what’s needed?

So …,. my first experience with the MAX did not go well. When I arrived and told the MAX instructor that I had T1 diabetes and wanted to watch for a bit to get an idea of the routine, she told me “It would be okay. Just make sure to keep my epi-pen near by”.

I stared at her before I responded that Type 1 diabetes was not an allergy. She seemed to have no patience in listening or understanding so I … I sat and watched and left. I never went back.

I have the ACC-CHEK insulin pump, iPhone 6, AND the CGMS receiver. It does not all fit in the SPI-belt.

Quite honestly, this is too hard. I gave up. Screw it. The supposed diabetes care team – right now that’s just my endo – can only provide generic advice. I want a team similar to the one’s that athletes with T1D use.

I think that athletes largely manage themselves. It seems like you want assurance that there’s a solution, sort of an “engineering” fix that willwork 100% of the time. I don’t think such a thing exists, except perhaps to get into a “flow” state and figure out a way to roll with it, one way or another. Another thing I’ve observed is that in some types of exercise, you get an insulin discount, need more carbs or to kill your basal to make up the difference. As I exercised more and more, the discount seemed to change, and shrank over time, making it another thing to keep an eye on.

None of this should keep you from trying to find some type of exercise you can do @Khurt_Williams, it’s hard but rewarding!!


Thanks for the honest answer. That’s what I really want. Honesty. No BS, “it’s easy” crap I’ve been getting from the endo.

I went for a 30 minute walk before lunch today. Walk ended at noon. My BG before lunch (around 12:30PM) was 84. CGMS indicated BG was holding steady. Not dropping

I had 12g of carb and about 20g or protein for lunch. Right now (2:30PM) my BG is 54 and I have been ting to raise it for the last 30 minutes. I know I boluses correctly so this is most likely related to the earlier exercise. Good thing it’s the weekend. What would I do if I was running a meeting during the work week?

I usually test my BG a lot in those situations both to make sure what it is and also to keep an eye on how strong the calibration is. I tried a Dex last fall and found it more inclined to sort of overestimate the impact of exercise and respond to larger events, 1 hour run or whatever by reading lower so I meter a lot. The more I exercised the more it seemed like I had less impact BG wise as I got in shape, but then I was running races, which would be a whole different paradigm…

@Khurt_Williams – not sure if you are still trying to figure out your exercise routine, but here are my two cents. I have found that regular MODERATE exercise is what works best for my BG. What I mean by that is 4-5-6 days/week of no less than 60 minutes jogging or biking outside or elliptical at home/gym. Sometimes 15 extra minutes of low weights thrown in at the end. If I am lucky to have the time, I bike 15 mins to a yoga studio, do a 75-minute class and then bike 15 minutes back. For that I would even eat an apple either before or after the class, depending on what my level is at both those points.

High-intensity workouts do not hold much appeal in general and – more than that – when I tried a few times, I experienced delayed rises in my BG. No, thank you.

So for the moderate types of activities I recommend, figuring out where to place my pump and CGM is not an issue – I would do it the same as always: various spots around my abdominal area and top of buttocks. There are a few yoga poses where I might need to slide the pump to another side of my body, but it’s not a big deal. Everything remains clipped to my belt during all of these workouts, just as it would during the rest of the day wearing normal clothes.

I hope this is helpful and gives you some ideas. Let us know what you have figured out.