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[IP] Exercise and Insulin Adjustment

My daughter is 12 years old and has just started using the MiniMed 508
insulin pump one month ago.  So far, her bg's seem to be quite variable and 
not all that different from when we weren't on the pump. We're testing a lot 
and correcting, particularly in the night but still don't seem to be making 
a lot of progress.

Her nightime bg's are running high, as are many daytime readings as she is 
forgetting to bolus many days at lunch when she's away at school.  She's 
also a high level ringette (similar to hockey) player and is on the ice for 
games and practices approximately three times per week. We have been 
experimenting with adjusting her insulin relative to game time in an attempt 
to regulate her blood sugar level during and after exercise times as well as 
avoiding post exercise lows. She is travelling to a ringette tournament this 
weekend to play five games, and I'm concerned about her bg's during that 

Sometimes her bg's are in a good range to begin the game (i.e. 8 or 9) but 
when she has a small snack, boluses (reduced by 50% for the high level of 
activity), and then disconnects (due to the level of body contact) during 
the game (which is the suggestion given by our diabetes educators at ACH), 
she comes off the ice being very high. Then, the concern is bringing her bg 
down again within a reasonable time frame without having a post exercise low 
in the hours to follow.

(We have been told to wait 30 minutes before correcting the post game high. 
We have tried drinking lots of water during that waiting period as well, as 
dehydration can be a factor in high bg's during exercise.)
Giving a correction of 50 or 75% still seems to leave her high. If the game 
is in the early evening, she then goes into the evening and early morning 
hours very high and the rest proceeds accordingly.

We've also contemplating not eating prior to the game but lowering her
basals during and after exercise to reduce the chances of lows.  The fact 
that ringette is anaerobic exercise, i.e. very high bursts of energy in 
short shifts throughout a 60 to 90 minute game, is probably a factor in how 
and when the insulin should be delivered for optimal benefit. Walsh's 
Pumping Insulin book, states that with anaerobic exercise, one should 
consult your physician for insulin adjustments, but he doesn't elaborate 

Does anyone have suggestions regarding any of the above?  Do you have
athletic adolescents who have also experienced similar challenges and who 
has found a process that works for them? I know everyone's experience is 
different but any suggestions you or anyone else could provide would be of 
help.. .)

Does anyone know about the International Diabetic Athletes Association and 
if their group or asssociation provides useful information for young 

Also, if anyone knows about Palm Pilots and accompanying diabetic software 
for use when figuring out carb counts while eating out in restaurants, could 
you provide the name of the software that you're using.

Thanks for all your help.

Lori, Mom to Kirsten, age 12

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