Backpacking and Basal Adjustments

I recently went on a backpacking trip with my two sons. This was a trip into a lake in the mountains of Eastern Oregon and the hike into the lake was about 10 miles. We packed all of our gear in with us in our backpacks. The trail was not too steep, but a fairly steady 9% grade. The hike in took about 7.5 hours. The hike in is 7+ miles of up-hill and the rest is going down into the lake.

I was very concerned about Basal Rates because I am still fairly new to the pump (2 months on a MM508). My doctor recommended lowering my rates by 25%. I did not think this was a enough, so 30 minutes before I started hiking, I set a temporary basal rate that was 50% of my normal rate.

As we hiked I checked my blood sugars every 1-2 hours. I continually ran between 65-90 and ate many snacks. When my temporary basal rate ended we were still about 1 hour from our destination. At this point I was 65, so I ate a snack and suspended my pump.

After arriving at the lake it was getting dark, so we set up our camp ASAP. I unsuspended the pump and returned it to my normal basal rates. After 30 minutes or so, my blood sugar had risen to about 250, so I bolused 2 units.

My blood sugars were in my target range the rest of the evening and in the following days.

This hike was done with a 50-60 lb pack and went from about 5,500 ft in elevation to 8,000 ft.

For the hike out I was only 75 before we started, so I ate breakfast and did not bolus. I then set my basal rate to 25% of my normal rate. I was running about 200 when I arrived back at the car. I then returned to normal basal rates and took a small bolus to get me back in my target range.

Useful Info for others:

• I seems that a basal rate of 25-50% of your normal rate works pretty well. For extremely tough sections you may want to suspend the pump. You will have to experiment to figure out the "right" setting for you.
• Lower your basal rate 30 minutes BEFORE starting your hike.
• After finishing the hike return your basal rates to normal and check your blood sugar 30-60 minutes after. For me, my blood sugar rises, so I need to bolus a couple of units to correct. Another approach would be to return your basal rates about 30 minutes BEFORE ending the hike if you can calculate that easily.
• Carry glucose tabs, gel, glucagon, and snacks while hiking.
• Check your blood sugars often (1-2 hours) while hiking.
• Carry a backup pump if you are going to be in a very remote area. A backup glucose meter too, extra sets, insulin, syringes, etc...
• You will sweat a lot while hiking, so use tincture of Benzoin and/or extra tape to help hold your set in place. Dont' forget to drink LOTS of water.
• Most of all, HAVE FUN and KEEP PUMPING!