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[IP] Re: insulin-pumpers-digest V3 #412

I think that's BS.  Everyone is different in handling
exercise.  My personal "regimen":

If I haven't bolused in 4-5 hours, then I disconnect about
15 min prior and stay disconnected for the duration.

If I work out in the morning before breakfast, I also
disconnect.  I must
bolus 2 units when I reconnect or I go high.  This does not
occur at any other time of the day.  If I am on the high side
upon waking I must use the full correction amount (usually
if I am doing corrections or eating prior I only bolus for
about 50%).

If I HAVE eaten lately or bolused lately, I disconnect but
also need 25 g of carbs.

By the above, with of course a few mishaps from time to
time I can maintain an exactly stable blood sugar for
the duration. 

Part of what is key to that though is that I also do fairly
intense stuff.

Now for longer periods of exercise it's much different.
For a thirteen mile hike with a elev. change of 4,000
ft. (7 mi up, 6 mi down), I had to disconnect for about
the first four hours.  I also ate 30 g to start with
and still ran low and had to continue to snack.

About the fourth hour I noticed a mild rise and cut
my basal back in a .2 (usually .5).  From then on out
if I ate I bolused 50% of the value needed and maintained
fairly stable numbers... if I hadn't kicked in a basal
at that point (gee, made this mistake before?) I would
have been sky high!

Hope this helps...

>Date: Sun, 22 Aug 1999 19:41:00 -0500
>From: "Anika Schon" <email @ redacted>
>Subject: [IP] How low can I go, on basals?
>I saw my Endo last Saturday. We are working out basal rates. One of several
>disturbing dictums she gave me was that I should not lower my basal by more
>than 50 percent before exercise because that would give me too little
>insulin and put me at risk for ketosis. However, halving my basals for
>exercise (which takes them down to .3 units hourly) is not adequate for
>avoiding reactions. Therefore she decreed, I must still eat before exercise.
>    Well, one reason I wanted the pump was to avoid exercise lows AND having
>to eat something every time I get on my bike..
>   I'm questioning her competence on this and a few other points. I believe
>I've seen some on this list reduce basals by 100 percent sometimes before
>exercise or even just for some piece of the night, which means a basal of
>0.0 for whatever length of time that is set.
>    What do you  think. Is .3 too little insulin? Is it possible to go
>ketotic despite having a small amount of insulin? Is my Endo, as I suspect,
>full of beans?
>Anika, the questionable
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