what’s the rule of thumb when it comes to exercise and the pump? do you suspend, reduce, or continue basal, if so for how long. etc. very confused and don’t want to suffer from lows
j
I was told that you could shut off the basal or remove the pump (if you’re going to swim, for example) for up to 2 hours, but no longer than that. If you’re doing a form of exercise that is going to take much longer than that (say, hiking or marathon running), you’d probably want to reduce it rather than shut it off completely, because you’ll need to keep some insulin in you to make sure your cells can continue to get energy from the glucose in your blood. I was also told that you want to keep pretty close tabs on your BG during exercise and keep glucose tabs or Gatorade close at hand because you can’t really gauge the rate at which you’re going to use glucose while you’re exercising.
This is really hard, as a 15+ year pump wearer, cyclist, weightlifter, hiker… I can tell you the answer is either depends, yes, or no. Get Sheri Colberg’s book and use trial and error.
rules of thumb that work for me:
Long (>2 hr) bike ride = ~50%
Short ride = no change
weight lifting = no change + 0.5 u bolus at the end
hard workout (ie crossfit) = 50% while working out, 2 u over 2 hr after workout.
hiking up for more than 0.5 mi = turn it off
hiking flat ground = 0.75% for first 2 hr, then 50% after that.
I think 45 minutes is the max you will want to disconnect/suspend…
I adjust my levels similarly to TS - I generally do running and cycling. Under 1 hour exercise I don’t adjust my levels at all, 1-2 hour duration I would drop it to ~75%, 2+ hours I would drop it to ~50%. Or course I am also refueling for anything over 1 hour duration.
your levels are going to vary - adjust and monitor just like you would under any situation.
At first I was suspending it but I was going high about 2 hours later - that did not happen on MDI. I read someone else say that she had that same problem so now I just cut back back some.
I take mine off but no longer than an hour.
To make it easy, I would start at cutting back 50% on your basal starting an hour before and going 30-60min past your work out to help with lows. If you have a starting point that you can try for different exercise then you can see trends and patterns that will help you figure out what your body needs. Every person is different when it comes to insulin! Good luck!
I remove mine too but if it is for more than an hour, when I replug it, I bolus for the basal I missed after the first hour.
and if you’re reducing your basal do it an hour or two BEFORE you start exercising to get past the peak of your insulin effectiveness. Return to you normal basal right after you’re done exercising.
Monitor frequently until you get the hang of it - every 30 minutes or so. Always have a meter handy (the one touch mini is ideal for this) and always, alway, ALWAYS have some fast acting carbs handy. I prefer glucose tabs and/or running gels.
My 2 cents.
Terry
When I am in the woods hunting at 4:30am. I have a second set of basal rates during that season. Even with that, I temp basal to off for one hour and only bolus for about 2/3 of the carbs I eat at 3:30am. I have a 1.5 mile hike up the side of a mountian. When I get to my stand I sit and wait for 20 minutes and check my BG even though I use the Dexcom CGM.
As others have suggested, it really depends on what you’re doing, what you’ve eaten, and how much active insulin you have on board. Colberg’s book is a great investment. The best times for me to run are 1) immediately after a meal, for which I don’t bolus and set my basal to 50-75% for 30 min before and 30 min into my run, or 2) several hours after a meal when there is no active insulin, for which I’ll set my basal to 0 for 30 min before and to 25-50% for the 1st hour. I never suspend completely for more than 60 min or I risk spiking very quickly and that will quickly kill a run or put you out after it.
BUT what happens is not always predictable and I frequently make adjustments based on rises/falls and unexpected events (like getting po’d by a stupid driver and working extra hard as a result).