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Re: [IP] Disconnecting at Beach

On Sun, 7 Jun 1998 email @ redacted wrote:

> Michael,
> Could you please review Lilly's insulin routine when she goes to the beach
> etc.
> and chooses to disconnect from her pump? I will try to print it out for
> furthur use later.
Wellll.... it's kinda complicated. If she intends to swim either in the 
ocean or pool and her intention is to use up a lot of energy (like a swim 
team work out) then she disconnects and forgets about the insulin and in 
the case of swim team, may eat as much as 10 - 15 grams or carbo an hour 
just to stay even. When playing, the senario is different. For river 
rafting or tubing, she does a bolus for her basal rate for the next 4 
hours using R and checks every hour or so just to make sure she is on 
track. The river water is about 60 degrees or so and can pull her down 
(bg's ) if she gets dunked to much. Usually, however, the play does not 
cause any bg variation that is really noticeable. She can manage on R 
alone with no pump quite nicely. She hooks up to bolus for snacks or meals.
When doing those kinds of activities, she raises her target bg to 120-150 
just so she does not risk a low while "busy". This doesn't always work 
perfect, but it works pretty well. She uses the same sort of strategy for 
soccer as well. An hour and a half or running up and down a soccer field 
can require 5 - 15 grams of glucose by half time (when she checks) if she 
just disconnects before the game (insulin is still in) and she usually 
does not make any adjustment for lost insulin during the hour and a half. 
She will typically run 20 to 50 point lower for up to 24 hours after a 
hard game. Many times she just turns her hourly basals down a tenth for a 
day or two, then return the to 'normal?' when she starts to run a little 
high again. It is a very dynamic thing.

We noticed a couple of years ago that even skin diving in warm water 
(Hawaii) requires carbo intake or she gets low. We're going to Catalina 
for a week of skin diving and camping at the end of the month, so we'll 
have some more info on bg effects when we return. Probably something like 
3 Ritz crackers an hour or maybe a power bar every two hours. We will 
have glucose gel in those nice little sealed twist off plastic tubes 
WITH US while we are paddling around off-shore. :-)

I don't know if I answered your question quite the way you wanted, rather 
I tried to explain how we plan and strategize to make it work.

> > 
> Also-why can't you use plain old R in the pump instead of the buffered R?
AS far as I know, many people use standard Humulin R quite nicely in 
their pumps. Lily started on Velosulin and we have simply continued to 
use it. Since she now mixes, it is probably better to use  The Velosulin 
since it is supposed to use the same buffering agent as Humalog.

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