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Re: [IP] Re: Humalog and Exercise

> How is everyone else dealing with Humalog and prolonged exercise.
You may wish to consider mixing a little R or V with the H to take 
the erratic edge off the rapid lows. Just a thought, it works very 
well for Lily.

> (Especially the kids).  Justin had his second worse reaction since
> his diagnosis 11 years ago.  The reactions seem to hit harder than
> before on regular.  The other day he knew he was low - drank some
> juice and started to come close to passing out.  I got him more
> juice and some crackers and he recovered real fast but it was scary.

Glucose tablets are the fastest. Crackers second -- chewing them, the 
saliva converts the starch directly to glucose without further 

> and he was at 37.  (He had been playing basketball).  
> We told him that before any exercise like that he needed to test
> and treat anything that was even below 100 but do you have any
> ideas of other things that might help.  Does anyone reduce basals
> or reduce boluses?  We've tried cutting the food bolus in half

Ideas, yes.  Daughter Lily has pumped for 4 years and does 
competitive swimming and soccer as well as recreational skindiving.
All of these activities cause big variations in energy and insulin 

First, Lily targets her exercise bg's for 100 to 150, she does not 
engage in any physical activity if she is under 80 or over 165. That 
must be fixed first. She uses a One Touch Profile which reads 20% 
lower than the meters that test the plasma, so calibrate your 
thinking accordingly.

During swimming workouts, she needs no insulin + 10grams or more of 
carbo an hour just to stay even.

Soccer can be accomodated by eliminating insulin an hour before the 
game then reconnecting after. However, usually she forgets to 
disconnect until the game, so she needs about 15 grams of carbo to 
supply energy during the game, sometimes a couple of glucose tabs at 
half time if she's very busy and never stops running.

Recreational swimming is just about a push. If she takes off her 
pump, she can go all day with pretty stable bg's if she is in and out 
of the water and swimming most of the time. If she gets out for an 
extended period of time to play, etc.... she just hooks back up.

Skindiving (with a full wet suit) with moderate swiming (easy stuff) 
burns the same amount of energy as competition swimming. She needs no 
insulin and must have carbo intake of 10 to 15 grams an hour to 
prevent getting low. This is usually taken care of by half a Power 
Bar or something like that.

After particularly strenuous activities, her night time basal 
requirements will typically run 0.1 u/hr less than normal for 12 to 
24 hours.

Your mileage will vary considerably with each activity. You 
need to do some simple measurements for the sports and exercise you 
do regularly. Do the activity and check bg's every 30 minutes or more 
often if they are very strenuous. Correct the bg's with glucose, and 
remember to correct for the expected drop in the next 30 minutes as 
well so you don't end up crashing.

Likewise, for strenuous activities, check your night time bg's a 
couple of times, like 2:00 am and if they are low, again in 2 -3 

It is a lot of work to do all this, but once you have a good profile 
of body response, you know what to expect. I does get easier, at 
least it has for Lily. She is her own woman now, in good control of 
her life. She is at Mt. Camp right now on a 3 day overnight somewhere 
in the Sierras. I hope to get a letter from her when she returns to 
the camp.

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