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Re: [IP] pumping and ice hockey

Gus (age 8) plays an hour of hockey 3 times a week.  At a clinic during
December 1999 (when he was on MDI)  he skated for 2 1/2 hours at a time with
a 15 minute break after the first 75 mins.  We found him running high during
the break...in the 300s.  This past December (when he was pumping)  he'd
bolus for and eat a normal breakfast, disconnect during his ice time after
bolusing for 1/2 of the amount of insulin he'd miss during skating.  During
his regular weekly practices and/or games he tests beforehand, disconnects
if he's in range, and tests afterwards.  He occasionally needs a glucose
tablet during the hour he's skating, but not always.  A sports induced
"high" is usually over after about two hours.  Our endo told us that
adrenaline produced during sports can cause a high.  If we over medicate for
this, Gus can go low later in the day (or night.)  Reading this over, I
realize it may not be that helpful....Can only add that Gus's numbers during
and after sports have been more predictable while pumping than when on MDI.
Also, hockey in a cold environment seems to require disconnecting to get
good numbers, while for soccer he stays connected.  Go figure!
----- Original Message -----
From: Michael <email @ redacted>
To: <email @ redacted>
Sent: Saturday, February 10, 2001 2:36 PM
Subject: Re: [IP] pumping and ice hockey

> > Does anyone on the list play ice hockey, or have a child who does?
> > My 12 y.o. son plays and/or practices at least 4 times a week,
> > usually in the early evening. He eats dinner between 1 and 1 1/2
> > hours before skating and boluses accordingly.  We're having
> > difficulty with his post-hockey BGs.  He tests as soon as he can
> > after he gets off the ice (between 10 and 30 minutes) and is always
> > above 240, sometimes as high as 500+.  He boluses and the numbers
> > start to come down within a couple of hours.  Before going on the
> > ice he follows these guidelines:
> Strenuous activity requires that the cells be able to metabolize
> glucose which in turn is dependent on adequate free insulin available
> in the blood stream. For athletes this usually results in one of two
> scenarios -- sometimes both, but not at the same time.
> 1) the extra activity burns all free glucose and results in a rapid
> low
> 2) the extra activity requires lots of glucose, but absent adequate
> insulin the liver is signaled to dump and the result is a high --
> because there is inadequate free insulin in the blood stream, the
> cells cannot get enough glucose and the feed back then signals for
> more glucose.
> My daughter has seen both things happen to her playing soccer,
> particularly on tournament weekends.
> This is a YMMV kind of thing. Lily's approach was simply to make sure
> that there was adequate insulin IN and check at half time or signal
> her coach to pull her out if she feels low. This has worked well for
> her and rarely now does she have a problem with highs or lows.
> my thoughts, YMMV
> >
> > BG under 100:  he eats 30 grams of carbs
> too much carb -- how about 12-15 g + insulin for anything that would
> push him over 100-125
> > 100 - 150: he drinks a Gatorade while skating
> too much carb again, try mixing 50-50 with water
> > 150 - 250: he drinks water while skating
> > if his BG is going down (it's lower than his last reading) he eats
> > something.
> dunno, If Lily gets that high while playing she boluses and will not
> play until she is 190 or less.
> her play range is 70 - 190, but there has to be some control measures
> taken and in place if she is at one end or the other. The magnitude
> and direction of bg's also have to be known. Her standard equipment
> is similar to your son's. -- Glucose tabs, power bars, Gatorade,
> humalog.
> All of this was harder when she was your son's age. Seems to be a
> little easier now that she is 17. I guess metabolism and growth
> factor into this but I have no clue how.
> >
> > We've tried relating it to every variable imaginable but can't seem
> > to come up with any kind of pattern. Occasionally, he'll have a low
> > in the middle of the night after hockey.
> This is pretty common for us. After particularly hard play or more
> than one game, Lily will lower her basals a tenth for the night to
> prevent a night time crash. It has been pretty predictable for her
> after back to back games.
> >
> Michael
> email @ redacted
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