Baseball season is coming up and I want to make sure I have considered all of our options.
Background, my son is 14, plays competitive baseball and is currently wearing a pump and CGM. He is not a large kid and doesn’t have a lot of extra spots to put infusion sets. We have failed with a few thigh placements and so we currently rotate left belly, right belly, arm that doesn’t have the CGM, then left upper buttocks and right upper buttocks. An important note, he is a catcher and will have to perform a considerable amount of blocking (two of his pitchers throw a lot of balls in the dirt).
We were considering keeping the pump on him in a padded belt with the pump rotated behind his back when catching and turned back toward his rear hip when hitting. But this would require keeping his sites just to the non-sliding upper buttocks and non-CGM arm, and the season is long (4.5 months) and that doesn’t seem like a recipe for good site rotation. Also, in our preliminary tests sometimes the tubing impinges his ability to throw with the arm site, and that won’t work well for the season.
So, we talked with another family that dealt with this, whose son is now in college and they suggested going “untethered” by using long acting insulin for his basal needs and the pump only for meals. We aren’t looking forward to this because he has very different basal needs throughout the day. Currently we have four basal settings that differ by more than 0.04 units per hour. Quite high at night to deal with growth hormone, much lower from 11-4, then lower still until dinner. This arrangement has worked well, and kept his A1c in an ok range, I cringe to think what his A1c would be if we go back to just Lantus for his basal needs.
So I am turning to this wonderful group to see if anyone has any other ideas. We would be most comfortable with the pump not being on him during the game, but are willing to consider anything.
How funny, my son is 14, plays baseball, he is a catcher and wears a pump and CGM.
We use Omnipod, which makes it easier to manage since there is no tubing involved. I know some young athletes that use the “untethered” option, others would disconnect, but I know that is complicated. During baseball season we can’t use my son’s right leg or stomach for any device, between the base sliding and sweating, it just doesn’t work.
I’m sorry I don’t have a specific solution for you. Good Luck!
What is his basal rate during games compared to the rest of the time? If his basal rate during games is consistently lower than most other times, the untethered approach would be very helpful.
The Lantus shot doesn’t take the place of his entire basal, just the minimum level. So during games, if his basal is at the minimum, Lantus is covering that. Once the game is over and he is back on the pump, the higher basal amounts are covered by the pump once again.
Basically, the Lantus and pump basal add up to the normal basal amounts. The only time it affects him is during games when only the Lantus is working. But if the games are when he is at the minimum, the net affect is that there is no difference to him. Happy to give examples and clarify.
Another option would be to look at the OmniPod tubeless. Even if it is just for games, and you don’t have insurance for it, you can buy pods for about $30 a pod, and one pod lasts 3 days.
Not sure if they let kids slide head-first now. That would be another option if it is allowed. Pump on the butt, and sliding head-first would keep it out of the way.
Yes, during games his basal needs go down, he was usually running at 60% during fall ball. Hmm, so we would determine the Lantus for the lowest basal rate and then put in a program that adjusts for the increased insulin on top of the lantus shot. I hadn’t considered that. That is an excellent idea. I will call his diabetic team and see what they think a good conversion for his current basal rate would be.
The Omnipod is something we might think about especially for tournament weekends; i.e. a new bat would cost about as much as a season’s worth of Omnipods for tournament weekends. I assume you program through the PDM, how much do they run?
Yes he can slide headfirst, but at this level, he needs to be able to slide into second with spikes first to get the attention of the second baseman and avoid the double play, if possible.
I agree that this might be a good suggestion. I have a 14 yo baseball player - he uses OmniPod and Dexcom, so no experience with the tethered approach. But I know of a now grown man, who when in high school went untethered while playing soccer. He split his basal in half on the pump - the other half from a long lasting injection. Worked wonderfully. I would definitely try this myself in the same situation. Good luck.
One other thing to mention, possibly he is already doing something like this. With baseball, it is a little bit easier because every 1/2 inning he gets some time in the dugout. This would be a good thing to add to each inning’s ritual: Do a BG test, and if necessary, reattach and correct, and then detach again before taking his at-bat or returning to the field.
I know people love their CGMs, but with sports the CGM lag is a bit more risky. I’d highly encourage BG tests between innings.
FWIW, Brandon Morrow who was a RHP for the Blue Jays and has now moved on was a type 1 diabetic and pump wearer. He used to detach his pump when he went went out to the mound, and reconnect it between innings. He also checked his bgs between innings. One more way to handle things. He was a favorite of mine as he was diagnosed at the same age, 18, that I was.
Roger, thanks for mentioning this, I think this would work well if he only pitched. With the positions he currently plays, he would be unhooked for most of 3 hours, which might work, but I am not sure. Thanks for the comment, and it is amazing and inspiring how many baseball players are in the MLB that also have type 1. i.e. Brandon Morrow, Adam Duvall, Mark Lowe, Dustin McGowan. The sky is the limit.
Hey, my brother deals with this also, he’s a catcher, pitcher and shortstop. He will either put his pump in a belt in front of him(so he doesn’t slide on it) under or over his shirt. He is 12 and is pretty skinny also. When he has his site in his butt, he’ll put batting gloves in his back pocket so that when he slides it “pads” it. He hasn’t had a problem with his site coming out so far.
Hope this helps!
Playing catcher certainly complicates things to a certain degree with all of the squatting, blocking, extra equipment etc. Having said that, my suggestion would be the OmniPod if you don’t want to go the MDI route. I would think a tethered pump would be very inconvenient.
I coach travel baseball and throw a lot and never had any issues with my OmniPod on the back of my left arm. I honestly think this would be an excellent solution for your son.