Skiing, pumping , testing

My son is starting ski club in Jan., and I was wondering if anyone out there who is also a skiier can give me some helpful pointers on managing their diabetes while hitting the slopes.
Thanks ,

Meters and strips are effected by cold temperatures. The best I’m aware of has a low temperature limit of 4 C (~39 F) . I don’t know what the worst meters are rated for, but I have one that is only rated to 10 C (50 F). Accurate testing outdoors in cold weather is not possible.

Some people think that you can get an accurate reading in cold weather by keeping your meter and strips in a warm pocket until you need them, but it does not work. The meter may be warm but the strip cools off as soon as you remove it from the vial. Meters that check the temperature before allowing a test may be fooled by this situation. iI’ve done extensive cold weather calibrations of my various meters and none of them are even close to being accurate. I’ve seen very significant changes in readings taken just minutes apart (room temperature readings, put coat on with meter in pocket, walk outside building and sit in car, take cold readings). Of course, I don’t know how cold it gets where you are. -10 C (-14 F) is a nice warm winter day for me but way too cold use a meter.

I thought that a meter with multiple test strips might reduce the problem since the strips wouldn’t be cooling off outside the meter, but my multistip meter was a Breeze, and it was only rated to 10 C. It was so bad in cold weather that I once set it off just by breathing on the strip.

So, my advice is to forget about trying to use a meter outside in cold weather. Carry and eat snacks, or come in for periodic warm ups and tests.

thanks so much for the advice, David. I had no idea about the strips and the cold.

Great question and I am interested in everyone’s replies. I teach skiing to children on the weekends and this new season will be my first since I was diagnosed. Good to know that the meters don’t work in the extreme cold. I’ll have to make sure to test between lessons and leave my meter in the lodge.

I can “second” the great information shared by David about cold weather and BG meters. If you are going to carry your testing supplies with you I would still recommend keeping them warm in a pocket so that you won’t have to wait that long once you go inside the ski lodge to test.

I skied all last season on the Dexcom continuous sensor . .I kept the receiver (BG display) in my chest pocket simply for easy access, but I guess for warmth as well since it is an LCD. If I saw a concerning BG pattern on the display I would plan to check via meter inside at the first opportunity.

In terms of wearing the pump while skiing, I would recommend one of those soft waistband pocket / velcro things, slide it so that the pump is in the middle of your abdomen, as far beneath your ribs as possible. Seems to me that you would be unlikely to fall there skiing, and if so, perhaps you have a little bit of cushion there. .and not rock hard abs ? (I discovered this after SHATTERING my MM 504 pump years ago . . . I had it tucket in my bra strap under my arm, thinking I wouldn’t fall there but I was skiing White Heat @ Sunday River, ME . . huge bump trail . . came crashing down on a hunk of ice on top of a bump, my arm flailing in the air, landed right on the pump, cracking it . . . .and my RIB ! You could actually see the outline of the pump in the bruise for upwards of a year later . . )

This may be a bit controversial (as some physicians do not buy into this) but if you believe your BG’s can be affected by stress and adrenaline . . .be very careful correcting high BG’s while skiing. I guess it would only count if you were an adrenaline junkie, or skied death defying trails but I guess if you were new to skiing the bunny trail could cause you to be sweaty from nerves even on the coldest day.

My surporting story; (feel free to skip this) I was skiing out in Breckenridge, CO about 10 years ago with my husband. We were skiing the #8 bowl on a beautiful day. My BG’s had been doing great . . last BG check 10 minutes prior was 131 . . At the top of the lift we decided to take a tiny 2 person J bar up the ridge, to the very top of the bowl. It was so sunny and warm my gloves, hat and goggles were stored in my backpack. 3/4 of the way up, when the J bar reached some sort of peak, a WILD storm blew in, affecting just the top of the bowl. Freezing temps, blinding winds with ice . . it took all of my strength to stay on the J bar (if you got off, it would be rock skiing down a cliff). I couldn’t risk attempting to get into my backpack for my gear . . . . I had a severe “icecream headache” from the plaster of ice accumulating on my head . . my husband and I were screaming to hear each other. My husband was going to ski the face wall of the bowl, I had planned to traverse the ridge and meet him beneath the head wall. When we got off the J bar, it was like we were in another world . .couldn’t see a thing, couldn’t even find the traverse trail . .we hunkered down behind the J bar machinery shack, got on our gear. . I wanted to traverse the ridge and for him to come with me, and yelled above the wind that it was too risky, we might lose the trail, become too exposed . . he wanted me to follow him over the head wall . .it was the quickest way out of the storm. When we couldn’t agree I started crying and . . . . he stood up skied 4 ft away yelled “FOLLOW ME” and then completely dropped out of site over the head wall.! I skied over to the edge (almost blew over the edge by the wind . . ) I called for him . . from my feet down . . there was a cloud . .foggy . . I coudn’t see what was down there. I could barely hear him yell . . STAY LEFT, QUICK TURNS, LEAN BACK, DON’T FALL . . . JUMP ! So I did . . The do not fall advice was clutch, as there were a couple of rock outcroppings that I had to turn around, and one I had to jump (without any time to think . .it was not graceful). My uphill pole hand was higher than my head ! Anywho . . I did fall once . .had a hard time finding the ski and getting it back on . .when we finally got to the base, I was shaking so bad, soaked in sweat, he helped me in. Grabbed a coke, and my meter to help me test . . we both thought I would be severely low . .BG 380 ! Re-test . . 420 ! Tested my husband (non-DM) 68 ! I didn’t trust it . sure my muscles hurt but that was from use, not from high BG. I wasn’t thirsty, I wasn’t tired, I didn’t have that weird feeling / smell / sensation that I usually get in my nose with high BG’s (anyone else get this?). So I took ~ 1/8 th of my normal correction dose . .and over the next hour and a half crashed to 40. Whata ride !

Oh my gosh, Deb!! I would still be up there, crying if that was me!

I’m glad you made it out alive. Not being able to see where I was going would seriously freak me out. It took guts to jump down like you did.
Weird, how the BG is just wacky at those times, huh? I will take your advice about tucking the pump up under the ribs/abdomen area. He will have a lot of padding, as he will just be learning on the bunny hill.

Place the pump far BENEATH the ribs . . actually right over the belly button. I wear the OmniPod now, so holders, straps or tubing is no longer an issue. I pay a little more attention to its 3 day placement, on either side of my belly button when I am going skiing.
How old is your son? Mine is 8, has been on skis since age 3, he doesn’t have diabetes but certainly knows everything about it !

Noah is 9, and pumping just a year- it’s been so freeing for him (and us) and he’s trying new things like never before. I wish we had started him on skis early, like your son.
We are in NH , and you can’t live here and not ski!

Good for Noah !
Ah ! We are NH wannabees . .We live on the South Shore of Boston . .it makes regular trips to Northern NE tricky when the first part involves getting thu Boston.

Hey, Lea,
I’m in NH too and teach at Ragged Mountain. Where will your son be skiing?

All I can say is TEST, TEST, TEST…skiing combined with the cold can bring you down SO quickly!!! AND CARRY SNACKS WITH YOU AT ALL TIMES. Keep your meter/strips close to body heat, say in an inside pocket close to the waist or chest, otherwise your testing will not display! Best to test indoors if at all possible…and when in doubt…snack. You’re certainly much more likely to run low rather than high!

I have experienced the same problem and it was very difficult to test out in the cold. I wear everything under my clothes so that the pump and meter are close to my body. Another option might be to leave a meter somewhere in the ski lodge where he can go to test.

He should keep some glucose tabs / gel in his pocket and tell him to eat a couple if he feels low, even if he can’t test.

I would also consider using a temporary basal rate (maybe 50-70%) starting at least one hour before he begins skiing and continuing until he would be done. This would prevent him from going low on the slopes. If he goes high, then reduce less next time.

Glad he’s doing this! I’m sure he will have a blast!!