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Re: [IP] Re: Humalog and Exercise


I'm glad that Justin made it through o.k. I wore my parents out during my
youth with events like this.

Two thoughts: (1) temporary basal reduction; (2) temporary basal reduction.

One real benefit of pumping is that you can reduce your basal rates
temporarily for exercise. Many folks start the basal reduction well in
advance of the exercise start time. With Humalog, this might be
approximately 1/2 hour to 1 hour in advance. With Velosulin, I start the
reduction as far ahead as two hours. This timing should match the expected
"onset curve" for basals with the insulin your son uses. Remember, YMMV.

It's generally better to reduce basals a little more than you think is
necessary, starting a little earlier than expected, since it's easier to
adjust for a high later on than it is to have to stop your activity and
deal with a low BG.

Justin might also notice his BG stays lower than normal for some hours
after exercise. He might need to continue the temporary basal reduction for
several hours after the activity ends. Test BG often to determine trends
after exercise.

You're right - he should *always* test before (and after) exercise. Testing
during exercise is the only way he'll ever know for sure how exercise
affects him, but that might be tough in a peer environment. Testing is the
*only* way he'll know if further adjustments to insulin / carbohydrates are
necessary. This needs to become a habit.

If I plan to exercise after a meal, I also reduce my meal bolus somewhat.
This isn't an exact science, and a certain amount of "guesstimating" is
necessary. However, with diligent testing, you should be able to discover
patterns, and apply what you've learned to future activities.

For unexpected exercise after a normal meal bolus, I sometimes resort to
the old "tried and true" snack technique. It's o.k. in these situations,
it's worked for me all these years. You might want to check that Justin
doesn't start to use "anticipated exercise" as a reason to snack without
bolusing, though (been there, done that). Then he ends up dealing with high
BGs later on, and it's a bit of a roller coaster to get back to normal.

I found the speed of onset of low blood sugar reactions to be very quick
when I was on Humalog. I didn't like that either. I needed to be extra
attentive to testing - it's the only way for me to deal with this
possibility. Velosulin gives me more "advance notice" when I'm going low,
so it's better for me in this regard.

It's important for your son to understand that the insulin is still
working, even though he's changed his schedule and plans. If he can
understand this and calculate how long it takes for the insulin to "wear
off", he should be on his way to managing exercise effectively.

Keep asking questions ;-)


Bob Burnett

mailto:email @ redacted
Insulin-Pumpers website http://www.bizsystems.com/Diabetes/