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Exercise and Diabetes
With Dr. Martin Draznin from March 26, 2001

Chat Room Administrator Mon Mar 26 2001 20:15:00 Eastern US
The 'Exercise' chat room is now open.

Mon Mar 26 2001 20:39:06 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
I'm here a bit early in case anyone is waiting

Mon Mar 26 2001 20:39:13 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
hello....

Mon Mar 26 2001 20:40:43 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
Hi Connie, were you planning to ask questions about exercise/

Mon Mar 26 2001 20:42:12 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
Well, I shouldknow what I'm doing, but I did go swimming the other day, and after "listening" to everyone in parents, decided not to bolus till after I got out of the water, that was a big mistake!

Mon Mar 26 2001 20:43:58 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
I"m planning on swimmng to try to excercise my shoulder which is gimpy, so it's not a lot of excercise with 1 arm! So it's going to take some experimenting over the next little while

Mon Mar 26 2001 20:44:09 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
What happened?

Mon Mar 26 2001 20:44:53 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
Okay, I'm new to this and cut your answer in half, sorry

Mon Mar 26 2001 20:46:22 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
I went really high, was 4.6mmol when I went in the pool, so I didn't bolus(fear of lows) When I got out 1.5 hours later my sugar was 16.9!! Could have also been cause a bit by the pain in the shoulder, I did try to use it a bit!

Mon Mar 26 2001 20:47:00 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
You didn't cut me off, I'm a slow typer, and did it in 2 sections!

Mon Mar 26 2001 20:47:37 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
Are you an Endo or Physio?

Mon Mar 26 2001 20:47:48 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
Well, yes it could, but the other thing is that when your body gets ready for serious exercise it really makes fuel available by raising the level of adrenaline, cortisol glucagon and growth hormone so it needs insulin to balance

Mon Mar 26 2001 20:48:11 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
I'm a Ped Endo

Mon Mar 26 2001 20:48:49 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
If my sugar is around 4, how much would you bolus for that?

Mon Mar 26 2001 20:49:04 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
oh my, I'm an oldy!!

Mon Mar 26 2001 20:49:24 Eastern US
Ellen (FL) (Zachary 13, dx'd 2/89, pump 5.5 yrs) from 152.163.213.58
Hi Dr. Draznin. Where do you practice?
Hi Connie.

Mon Mar 26 2001 20:49:41 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
ANd I know you can't give me exact #'s, I've been D nearly 33 years

Mon Mar 26 2001 20:49:51 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
Hi Ellen

Mon Mar 26 2001 20:50:29 Eastern US
BettyB (Chat Moderator) from 152.163.194.209
Hi all -- seems like I'm late! Has daylight savings arrived elsewhere in the world??

Mon Mar 26 2001 20:50:57 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
Hi Betty!

Mon Mar 26 2001 20:51:01 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
I don't really have an easy answer, I don't know your usual routine and so my guess is not likely to help. The reason I was asked to host tonight is that I wrote an article about this. Oh, my I am behind, okay I'm in Kalamazoo MI at Michigan State University Kalamazoo Center for Medical Studies

Mon Mar 26 2001 20:51:09 Eastern US
BettyB (Chat Moderator) from 152.163.194.209
Nope, guess, not you're all just a bit early! Thaniks for coming, Dr. Draznin!

Mon Mar 26 2001 20:51:12 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
We're early birds!!

Mon Mar 26 2001 20:51:46 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
glad to be here

Mon Mar 26 2001 20:51:47 Eastern US
BettyB (Chat Moderator) from 152.163.194.209
Hi, Connie and Ellen --

Mon Mar 26 2001 20:51:55 Eastern US
Ellen (FL) (Zachary 13, dx'd 2/89, pump 5.5 yrs) from 152.163.213.58
Hi Betty. I just noticed that you'll be speaking at the CWD conference in Orlando. I'm looking forward to meeting you there. Did you confer with Dr. Rubin about writing Sweet Adolescents?

Mon Mar 26 2001 20:52:44 Eastern US
Ellen (FL) (Zachary 13, dx'd 2/89, pump 5.5 yrs) from 152.163.213.58
Dr. Draznin, do you have many patients on the pump?

Mon Mar 26 2001 20:53:01 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
I want sweet adults!

Mon Mar 26 2001 20:53:43 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
Not a lot, but the number is growing. I've been in practice since 1983 when pumps were dangerous, so I don't push any particular style but ask for the family to be result oriented

Mon Mar 26 2001 20:54:30 Eastern US
BettyB (Chat Moderator) from 152.163.194.209
For the info of all, tonight's chat on exercise, kids and diabetes is hosted by Dr. Martin Draznin, pediatric endocrinlogist at Lichigan State University in Kalamazoo. Added to his expertise are experience in diabetes camping and his own sports activities -- I hope you've got lots of questions because we have a great resource tonight.

Mon Mar 26 2001 20:54:52 Eastern US
BettyB (Chat Moderator) from 152.163.194.209
Make that Michigan - Betty's typing strikes again.

Mon Mar 26 2001 20:55:13 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
LOL Betty

Mon Mar 26 2001 20:55:47 Eastern US
Ellen (FL) (Zachary 13, dx'd 2/89, pump 5.5 yrs) from 152.163.213.58
My son started pumping at age 7.5. It was absolutely transformational for us. But I would love to know more about your research re exercise. In this day and age of computers and video games, do you have suggestions for getting the kids self-motivated to go out and exercise without being coaxed?

Mon Mar 26 2001 20:56:00 Eastern US
Connie (MI) (Mike, 15 dx 12/97) from 152.163.207.72
Hi :-)

Mon Mar 26 2001 20:56:26 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
Hi Connie

Mon Mar 26 2001 20:56:40 Eastern US
BettyB (Chat Moderator) from 152.163.194.209
Martin, what would you say is the most common challenge that your families with youngsters come to you with regarding sports andmangaing their diabetes?

Mon Mar 26 2001 20:56:56 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
I must disappoint anyone looking for a real expert., there don't seem to be many, there aren't articles about youth exercise with diabetes, only in IDAA. The other stuff is about adults

Mon Mar 26 2001 20:58:05 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
I am going to have to get some help here, the answers and questions are leapfrogging! The biggest problem kids seem to face is up and down levels that aren't easy to explain

Mon Mar 26 2001 20:59:37 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
Same for adult Dr Draznin

Mon Mar 26 2001 21:00:18 Eastern US
Cindy (MI) (Matt-age 12, dxd 2-00, pumper) from 63.64.148.106
Hi

Mon Mar 26 2001 21:00:25 Eastern US
Connie (MI) (Mike, 15 dx 12/97) from 152.163.207.72
Up and down is exactly what Mike is going through right now --- we have a hard time getting enough exercise during the winter - we are in Mi too!

Mon Mar 26 2001 21:00:36 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
Hi! our big challenge is finding daily aerobic activity for Lauren in the cold winter. Summer is a snap (swim team, tennis) but winter, other than weekend skiing and 2X a week soccer and ballet, there is not much to do

Mon Mar 26 2001 21:00:51 Eastern US
BettyB (Chat Moderator) from 152.163.194.209
How do you go about helping families find solutions - is it just detective work about food, insulin, activity, etc.. or do you find any common "mistakes" that are often associated with the up and down blood sugars?

Mon Mar 26 2001 21:01:01 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
Yes, how to motivate? I am lucky, my only child loves to do things, and since he has serious asthma we had to learn a lot to help him stay in it. We played something for an hour one morning a week from as early as he could until he tired of his old slow dad at 13, but by then he was hooked!

Mon Mar 26 2001 21:01:21 Eastern US
BettyB (Chat Moderator) from 152.163.194.209
Hi, Cindy - welcome.

Mon Mar 26 2001 21:01:40 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
Yes Betty, it is ALL about detective work, the tools are there, the support from the diabetes team should be too and then we all put our heads together

Mon Mar 26 2001 21:02:34 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
hi Moira, I have toys in the basement but they are pricey, X-C skiing is fun but you need snow that is skiable and time

Mon Mar 26 2001 21:02:57 Eastern US
BettyB (Chat Moderator) from 152.163.194.209
I think yu hot on one of the best motivators, Martin - making the activity a family matter - not just trying to send the kids out to play or exercise. That's a tough sell when all their friends are inside, holed up with a video game!

Mon Mar 26 2001 21:03:38 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
My goal is to have her do exercise daily . . . I fall so very short in winter

Mon Mar 26 2001 21:03:44 Eastern US
Wendy from 12.78.71.28
Hi, Everyone, Moira why not basketball.

Mon Mar 26 2001 21:04:06 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
I think it will only get worse, we have to make a big change in things for our kids or we will face an epidemic of Type 2 diabetes in them, PE isn't always required, and not always fun so they turn off

Mon Mar 26 2001 21:04:37 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
We just discovered the answer to ski days and the pump (for her): No change in basal rates and NO boluses for meals. She had three ski days in a row with a 24 hr average bg of 99!!

Mon Mar 26 2001 21:05:21 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
there are probably as many great answers as there are families who look for them!

Mon Mar 26 2001 21:05:36 Eastern US
BettyB (Chat Moderator) from 152.163.194.209
Welcome, Wendy.

Mon Mar 26 2001 21:07:33 Eastern US
BettyB (Chat Moderator) from 152.163.194.209
Almost no PE left in schools out here in the West. it got lost in budget cuts, for the most part. Organized youth sports are big - soccer, rugby, football - but I think kids who are NOT competitve/team sports types have a really big chllenge.

Mon Mar 26 2001 21:08:26 Eastern US
Wendy from 12.78.71.28
Around here Betty, we have organized sports for the non competitive but stopped after 8th or 9th grade

Mon Mar 26 2001 21:08:45 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
Yes, I was not a very good athlete, just committed, so I was left out a lot until wrestling which called for more guts than skill, how many others miss out these days! Also, the soft drink companies pay for activities if the schools plug their sugar water

Mon Mar 26 2001 21:09:19 Eastern US
Heidyn (type 1 ) from 164.106.22.61
Hello

Mon Mar 26 2001 21:09:34 Eastern US
Ellen (FL) (Zachary 13, dx'd 2/89, pump 5.5 yrs) from 152.163.213.58
My son didn't have PE this year at all in school. He does go to karate a few times per week. Are there really 13 year olds out there who are willing to participate in family sports?

Mon Mar 26 2001 21:10:02 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
yeah my 14 yr old likes "dodge the parents" LOL

Mon Mar 26 2001 21:10:28 Eastern US
Lisa (LA) (Taylor, 13, dx'd 3/93, pumping) from 208.143.114.72
Hi All...only if it's biking or watersports Ellen:-)

Mon Mar 26 2001 21:10:44 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
Like I said, my son dropped me at 13, but I do know of families studying Tae Kwon Do at the school I attend, don't know if it's the answer for that many, it is a grind unless you absolutely love it

Mon Mar 26 2001 21:11:00 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
Lauren is no star either -- sadly her youth soccer coach never plays her anymore cause she is no good. I begged him this week -- told him I just want her out there running around -- she got six minutes of a 50 minute game. . . .

Mon Mar 26 2001 21:11:09 Eastern US
BettyB (Chat Moderator) from 152.163.194.209
Haidyn, good to see you!

Mon Mar 26 2001 21:11:24 Eastern US
Heidyn (type 1 ) from 164.106.22.61
Lisa, how is pumping:-)

Mon Mar 26 2001 21:12:03 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
Lisa!! You guys are pumping!! Congrats on your pump-ternity!

Mon Mar 26 2001 21:12:06 Eastern US
Heidyn (type 1 ) from 164.106.22.61
Hi Betty B.

Mon Mar 26 2001 21:12:10 Eastern US
Lisa (LA) (Taylor, 13, dx'd 3/93, pumping) from 208.143.114.72
Doing fine..for the moment..had a rough start but we're doing better.

Mon Mar 26 2001 21:12:23 Eastern US
Wendy from 12.78.71.28
Moira, how about a non competitive recreatinal soccer team, i coach and believe me it lowers my sugars..

Mon Mar 26 2001 21:12:54 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
There is walking, it works, but it takes organizing to get the family together, I still remember summer after dinner walks when I was a kid, magic!

Mon Mar 26 2001 21:12:55 Eastern US
Lisa (LA) (Taylor, 13, dx'd 3/93, pumping) from 208.143.114.72
Thanks Moira..congrats on resolving the school issues..

Mon Mar 26 2001 21:13:55 Eastern US
Brenda H. (mom of Marissa, 13--dx'd 9/89) from 10.0.1.3
Dr. D.--what type of precautions should our pumpers take with their pumps? Obviously, many must disconnect for water sports, but what about things like football?

Mon Mar 26 2001 21:14:03 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
Wendy sadly, that is what it is . . .

Mon Mar 26 2001 21:14:13 Eastern US
Lisa (LA) (Taylor, 13, dx'd 3/93, pumping) from 208.143.114.72
Taylor and I saw a martial arts movie today...now he's interested in it but only wants to concentrate on weapons training..boys!

Mon Mar 26 2001 21:14:27 Eastern US
BettyB (Chat Moderator) from 152.163.194.209
biking, watersports (with somebody to drive the boat), skiing/snowboarding (with someone to pay for the lift tickets) - those are still on my 14 year old grandson's list! Martin, for the kids who ARE active, it seems that the questions that come up most often on here are those about managing lows for practice and competition. Do you have any overall advice to offer in that area?

Mon Mar 26 2001 21:14:44 Eastern US
Wendy from 12.78.71.28
Moira, was it you who commented about the professional football player...

Mon Mar 26 2001 21:14:46 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
i think it is prudent to remove pumps for collision sports and use a sub cutaneous bolus, may with R instead of H, they are expensive and kids hit hard!

Mon Mar 26 2001 21:15:14 Eastern US
Wendy from 12.78.71.28
Moira, bring her to NJ she can be on my team...i will play her a lot....

Mon Mar 26 2001 21:15:53 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
Betty, the deal about lows is hard, some kids need less insulin by a LOT, others can keep up with sports drinks, then the GAME day is usually less active for most so it's another deal entirely

Mon Mar 26 2001 21:16:20 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
What comment Wendy?

Mon Mar 26 2001 21:16:38 Eastern US
Brenda H. (mom of Marissa, 13--dx'd 9/89) from 10.0.1.3
Marissa wore her pump when playing indoor soccer (just finished yesterday) and did get bumped often. She never mentioned any problems, though, and I wasn't too worried. It's not like the 49ers were tackling her!

Mon Mar 26 2001 21:17:00 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
Lisa if he does the weapons practice HARD it will work out a lot of energy and frustrations

Mon Mar 26 2001 21:17:04 Eastern US
Wendy from 12.78.71.28
must no have been you.....

Mon Mar 26 2001 21:17:06 Eastern US
BettyB (Chat Moderator) from 152.163.194.209
Moira - just saw the "dodge the parents" comment - great! lol

Mon Mar 26 2001 21:17:18 Eastern US
Lisa (LA) (Taylor, 13, dx'd 3/93, pumping) from 208.143.114.72
When Taylor was on injections, he had a tendency to go low 8 hours or so after the exercise..do any of you have that problem with the pump?

Mon Mar 26 2001 21:17:25 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
This will be Lauren's first summer on swim team with the pump. She is in the water a lot. I'm planning on hooking up and bolusing every few hours . . . . and I'm expecting her basal to be quite small in summer. . . . I'm nervous

Mon Mar 26 2001 21:17:33 Eastern US
Brenda H. (mom of Marissa, 13--dx'd 9/89) from 10.0.1.3
I always made Marissa test her BG before games and afterwards. She was always fine, but often plummeted later.

Mon Mar 26 2001 21:17:47 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
i have had patients who were required to remove pumps as well as all things other than their shin guards and uniforms, for the safety of others.

Mon Mar 26 2001 21:18:14 Eastern US
Lisa (LA) (Taylor, 13, dx'd 3/93, pumping) from 208.143.114.72
I'll tell him you said that Dr. D..I was resistant but it may be great motivation for exercise.

Mon Mar 26 2001 21:18:34 Eastern US
BettyB (Chat Moderator) from 152.163.194.209
So, to figure it out, we all just buy stock in meter and strip companies?? lol Seriously, I haven't found any other way to figure out those individual variations, but just wondered if you had any "pearls."

Mon Mar 26 2001 21:18:45 Eastern US
Wendy from 12.78.71.28
Lisa, i tended to kick high if i disconnected from the pump for softball...so i just kept it connected..and tested between innings...ate glucose tabs if needed.

Mon Mar 26 2001 21:18:47 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
Brenda, there is an explanation for late lows, the stores have to be refilled after the exercise so more snacking afterwards will be needed, I had hoped pumps would make this a thing of the past, but apparently not

Mon Mar 26 2001 21:19:20 Eastern US
Heidyn ( 19 ,type 1 ) from 164.106.22.61
When I was younger(ie a couple years back when I wasn't in collage)and I played on a soccer team, I'd always get high on game days because I'd be so nervous-practices I'd have to take less insulin

Mon Mar 26 2001 21:20:03 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
So Dr D, even with the pump, I will probably have to repeat my former injection routine of pumping her with fatty protiens on big swim days?

Mon Mar 26 2001 21:20:05 Eastern US
Lisa (LA) (Taylor, 13, dx'd 3/93, pumping) from 208.143.114.72
Some refs insist that they remove medical I.D. when competing in high school sports..any suggestions for dealing with that?

Mon Mar 26 2001 21:20:58 Eastern US
Wendy from 12.78.71.28
Lisa, i would tell them it is a medical necesity.......see what they say

Mon Mar 26 2001 21:21:35 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
for most serious athletes, the game is much less exercise than practice, it just feels like a whole lot because it's for real, Medic Alerts shouldn't be needed if the coach is responsible, they are for when nobody knows what the special needs are

Mon Mar 26 2001 21:21:40 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
Lisa I say what Wendy said and it's always okay

Mon Mar 26 2001 21:21:40 Eastern US
Ellen (FL) (Zachary 13, dx'd 2/89, pump 5.5 yrs) from 152.163.213.58
Wouldn't reducing the basal rates post exercise help ? At least there isn't any long acting peaking.

Mon Mar 26 2001 21:22:03 Eastern US
Wendy from 12.78.71.28
Otherwise the coach should know he is a diabetic...and if school has an athletic trainer...they should be aware

Mon Mar 26 2001 21:22:50 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
wow, this is too many strings at once, I just saw Moira's quiestion bout fatty proteins, help!

Mon Mar 26 2001 21:23:33 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
When Lauren was newly dx the endo told us to encourage "lifetime" sports -- exercise she can do forever . . . I thought that was sage advice. Tyring to push tennis and biking . . .

Mon Mar 26 2001 21:23:40 Eastern US
Ellen (FL) (Zachary 13, dx'd 2/89, pump 5.5 yrs) from 152.163.213.58
Dr. Draznin, it's ok - you're doing great with all this mental exercise :-)!

Mon Mar 26 2001 21:23:58 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
Basal rates afterwards can be slowed, but the other thing needed is replenishing the glycogen stores in liver and muscles that were used during the aerobic exercise, both things are needed some times, at others only one or the other

Mon Mar 26 2001 21:24:11 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
Sorry Dr D. we are a hard-chattin' group here!

Mon Mar 26 2001 21:24:33 Eastern US
BettyB (Chat Moderator) from 152.163.194.209
Just take them in order, Dr. D - we understand there's only one of you and lots of us! we're a self-sufficient lot -- than scroll back every few questions to see what's snuck past.

Mon Mar 26 2001 21:24:53 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
"sokay, it means you have a lot of energy for your kids!

Mon Mar 26 2001 21:24:58 Eastern US
sarah (dx'd 2.5 yrs, pump user) from 24.112.158.2
hi, sorry i'm late. i'm going to be coaching tennis in the spring, and i'm worried abt. going low

Mon Mar 26 2001 21:26:42 Eastern US
BettyB (Chat Moderator) from 152.163.194.209
Moira, that's great advice for everyone, that your doctor gave you - not just for kids with diabetes.

Mon Mar 26 2001 21:26:58 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
Hi Sarah, have you had any lows from exercise before? what sort of things caused them? What access will you have to things to keep your levels up while you are chasing your charges around?

Mon Mar 26 2001 21:27:05 Eastern US
Wendy from 12.78.71.28
Sarah..i coach soccer and basketball and sometimes have to ref both sports...i seem to go slighty high with exercise...i would leave the pump connected...and do a temp basal...of 0 or whatever i needed...a real trial and error thing

Mon Mar 26 2001 21:27:29 Eastern US
BettyB (Chat Moderator) from 152.163.194.209
Hi, Sarah. Welcome.

Mon Mar 26 2001 21:27:38 Eastern US
sarah (dx'd 2.5 yrs, pump user) from 24.112.158.2
how long did it take you to come up with your strategy?

Mon Mar 26 2001 21:28:18 Eastern US
sarah (dx'd 2.5 yrs, pump user) from 24.112.158.2
thanks betty!!

Mon Mar 26 2001 21:28:48 Eastern US
Wendy from 12.78.71.28
Sarah, i play softball during the summer..was put on the Pump June 9, of this year....took me about 4 games...to figure it out...with soccer...well i would forget and get some lows...because would play with the girls...

Mon Mar 26 2001 21:29:47 Eastern US
sarah (dx'd 2.5 yrs, pump user) from 24.112.158.2
yeah, that's kinda what i've beeen doing..have you found different excercises affect you differently?

Mon Mar 26 2001 21:31:58 Eastern US
sarah (dx'd 2.5 yrs, pump user) from 24.112.158.2
dr.d, i've had a hard time finding what works..i play tennis for 2 hr/wk, and i generally suspend and have a banana but i still varie a lot

Mon Mar 26 2001 21:34:03 Eastern US
Skipppy (Grandmother of Brooke Perry) from 63.175.212.70
How young are the patients they are using pumps on now?

Mon Mar 26 2001 21:34:53 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
It's very frustrating to have it be not the same all the time. I do advocate the use of the sports drinks because they are easy on the stomach compared to other sources of carbs and they hydrate you. Do you have different rates of insulin per carb during different times of the day? You may also find this changed during exercise. Unfortunately, we are biological and not machines, so there is day to day variability too. i would hope you keep at it

Mon Mar 26 2001 21:36:23 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
hi Skippy, how many Brooke Perry' ARE there in this world? I have one little guy about 23 months, scares me to death, but his mother is SO determined, I had no option. I usually ask whose idea it is, who will do the work and what the family expects from the extra and it is a lot, work they need to do to master it.

Mon Mar 26 2001 21:36:32 Eastern US
sarah (dx'd 2.5 yrs, pump user) from 24.112.158.2
dr.d,do you recommend a specific kind? gatorade" powerade etc? i'm not going to give up, i'm just running out of ideas!!

Mon Mar 26 2001 21:36:36 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
The beauty of Diabetes is just when you get it all figured out ---- It all changes!! Crazy

Mon Mar 26 2001 21:36:48 Eastern US
Lori (Ryan dxd6 11yrs old pumping) from 142.59.1.47
Hello

Mon Mar 26 2001 21:37:24 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
SKippy Lauren is 9 and I have to say -- it is COMPLETELY my job,. The pump is very hard work

Mon Mar 26 2001 21:37:27 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
You've got it Moira!
My insulin ratio is a guessing game! Carbs never react the same with me from day to day!

Mon Mar 26 2001 21:37:49 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
I don't have any one in mind, just try things. the more I do this, the less I know for sure except that we all have to keep track of what works and what doesn't for each person as an individual

Mon Mar 26 2001 21:38:05 Eastern US
Ellen (FL) (Zachary 13, dx'd 2/89, pump 5.5 yrs) from 152.163.213.58
Skippy, Kelly who chats in the parents room regularly, started her less than 2 year old toddler on the pump. Her daughter is now 3 and the pump is still working out very well for them.

Mon Mar 26 2001 21:38:57 Eastern US
Skipppy (Grandmother of Brooke Perry) from 63.175.212.70
Dr. D. This Brooke Perry is 8 years old and is a girl, she rides horses and dearly loves Dr. Draznin. When I seen her in school today and told her you would be on here tonight she said to tell you she said Hi. She is from White Pigeon, MI

Mon Mar 26 2001 21:39:31 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
But I'm thinking exercise will be easier to manage now that Lauren is pumping, right?

Mon Mar 26 2001 21:39:55 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
Well Brooke should know the whole team here thinks she is super!

Mon Mar 26 2001 21:40:44 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
Moira, the beauty of the pump is you can disconnect when low, it help quicken the treatment

Mon Mar 26 2001 21:40:57 Eastern US
Skipppy (Grandmother of Brooke Perry) from 63.175.212.70
Brooke will love that answer Dr. Draznin

Mon Mar 26 2001 21:40:58 Eastern US
Wendy from 12.78.71.28
Night Everyone....

Mon Mar 26 2001 21:41:26 Eastern US
sarah (dx'd 2.5 yrs, pump user) from 24.112.158.2
moira i've found it a lot easier to excercise with the punp, because it's so easy to change the amount of insulin you get. it just takes trail and error

Mon Mar 26 2001 21:41:54 Eastern US
BettyB (ChatModeraor) from 152.163.204.29
Hi, Lori. Welcome to that chat. Join right in with any questions you might have.

Mon Mar 26 2001 21:42:12 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
That's what I'm thinking Sara!

Mon Mar 26 2001 21:42:25 Eastern US
BettyB (ChatModeraor) from 152.163.204.29
Night, Wenday. Thanks for sharing tonight!!

Mon Mar 26 2001 21:43:17 Eastern US
sarah (dx'd 2.5 yrs, pump user) from 24.112.158.2
those are definitley the right thoughts to have!!

Mon Mar 26 2001 21:43:25 Eastern US
Connie (CO) (Marisa, 11, pumps) from 64.12.104.53
Dr. D what is your opinion about kids disconnecting for sports vs. using a temp basal decrease or extra CHO's?

Mon Mar 26 2001 21:45:24 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
I have seen both systems work. The only concern about long term disconnects is that the pump insulin is usually Humalog so it's gone when you disconnect. That means a subcutaneous bolus which will give a sharp peak in 45-60 minutes and be gone in 2-3 hr. Maybe R for the sub cut bolus? It has worked for past pump patients...

Mon Mar 26 2001 21:45:43 Eastern US
sarah (dx'd 2.5 yrs, pump user) from 24.112.158.2
has anyone added weight training into their current program? i think it would help, but i don't know where to start

Mon Mar 26 2001 21:46:02 Eastern US
Ellen (FL) (Zachary 13, dx'd 2/89, pump 5.5 yrs) from 152.163.213.58
My son can go off the pump for hours when he's at the beach and fighting the waves and walking in the sand etc. But in our pool where he just wades and floats, he can't be disconnected very long. He does fine 1 hour without the pump during karate.

Mon Mar 26 2001 21:46:08 Eastern US
Heidyn ( 19 ,type 1 ) from 164.106.22.61
Night everyone..

Mon Mar 26 2001 21:46:47 Eastern US
Skipppy (Grandmother of Brooke Perry) from 63.175.212.70
Ellen what night are the chats in the parents room?

Mon Mar 26 2001 21:47:09 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
Dr D: when disconnected a long time, why not just bolus through a quick hook up? and not a needle? I'm just curious . . .

Mon Mar 26 2001 21:47:14 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
Weights are good for strength, just be sure you know how your eyes are if you are going for bulk, the grunting maneuver raises blood pressure a lot and that can hurt microaneurysms....body shaping lifts, which are less than full capacity are probably not a problem

Mon Mar 26 2001 21:47:15 Eastern US
BettyB (ChatModeraor) from 152.163.204.29
Night, Heidyn, thanks for dropping by.

Mon Mar 26 2001 21:47:22 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
Skippy they are 24/7

Mon Mar 26 2001 21:47:56 Eastern US
sarah (dx'd 2.5 yrs, pump user) from 24.112.158.2
i'm definitley not looking for bulk, but i would just use hand weights

Mon Mar 26 2001 21:48:01 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
Well, not HAVING a pump myself, I am not as swift at the practical answers, that sounds great

Mon Mar 26 2001 21:48:05 Eastern US
Ellen (FL) (Zachary 13, dx'd 2/89, pump 5.5 yrs) from 152.163.213.58
Skippy, every night.

Mon Mar 26 2001 21:48:27 Eastern US
Skipppy (Grandmother of Brooke Perry) from 63.175.212.70
Ellen, at 9:00 pm Eastern time?

Mon Mar 26 2001 21:48:35 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
Weights are good for keeping muscles toned, be sure to stretch after so they don't tighten up

Mon Mar 26 2001 21:49:59 Eastern US
Ellen (FL) (Zachary 13, dx'd 2/89, pump 5.5 yrs) from 152.163.213.58
Skippy there are almost always people in the parents chat room - except when there's an interesting special chat in this room :-)!

Mon Mar 26 2001 21:50:32 Eastern US
sarah (dx'd 2.5 yrs, pump user) from 24.112.158.2
another question for you- how would you suggest one start a cardiovascular program, like jogging? i stopped over the winter, but want to start again. any tips?

Mon Mar 26 2001 21:50:42 Eastern US
BettyB (ChatModeraor) from 152.163.204.29
Moira, your idea is one used by a lotof ur active pumpers - and most also give their bolus to cover the disconnext time THROUGH the pump, just before disconnect -- so if the basal is.75/hr and they're going to be disconnect for two hours, they give 1.5u bolus just before unhooking... saves an extra poke.

Mon Mar 26 2001 21:51:27 Eastern US
Skipppy (Grandmother of Brooke Perry) from 63.175.212.70
Thanks for the info. I am not a parent of a diabetic, just a grandma, but I spend as much time with her as anyone else, so I like to stay up with what is happening.

Mon Mar 26 2001 21:51:46 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
Betty that makes sense. Thanks

Mon Mar 26 2001 21:52:05 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
cardiovascular programs are the ones you have to be the most in control of, because that's where you use energy aerobically to strengthen the heart. Start easy and don't do so much you are sore the next day, build up slowly

Mon Mar 26 2001 21:53:51 Eastern US
sarah (dx'd 2.5 yrs, pump user) from 24.112.158.2
ok, thanks a lot!!

Mon Mar 26 2001 21:53:58 Eastern US
BettyB (ChatModeraor) from 152.163.204.29
Skippy, there's a chat here tomorrow night on getting support from family and friends -- you ought to join in - a lot of parents would like to know about how you take part in your granddaughter's care -- 9pm Eastern with Dr. Wendy Satin-Rapaport

Mon Mar 26 2001 21:54:08 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
For aerobics, remember the rule of thumb, subtract your age from 220, that is maximum heart rate, work at 60% of max or so to get benefit, no heroes needed!

Mon Mar 26 2001 21:54:14 Eastern US
Skipppy (Grandmother of Brooke Perry) from 63.175.212.70
Ellen, if I understand this right, your son was about 8 when he started on the pump, right? I assume it has been good for him or he would not have been on it for 5.5 yrs.

Mon Mar 26 2001 21:54:25 Eastern US
Ellen (FL) (Zachary 13, dx'd 2/89, pump 5.5 yrs) from 152.163.213.58
I'd be very hesitant about giving a bolus before sending a kid into the ocean. I think when swimming it's better to give the missed insulin post exercise.

Mon Mar 26 2001 21:54:58 Eastern US
Ellen (FL) (Zachary 13, dx'd 2/89, pump 5.5 yrs) from 152.163.213.58
Skippy email me at CamelsRFun@aol.com

Mon Mar 26 2001 21:55:14 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
Skippy, I think that Brooke has a great family circle and I'm happy you are there for her

Mon Mar 26 2001 21:55:26 Eastern US
sarah (dx'd 2.5 yrs, pump user) from 24.112.158.2
would you take the pulse after the workout?

Mon Mar 26 2001 21:56:12 Eastern US
BettyB (ChatModeraor) from 152.163.204.29
Folks, we've only got a few more minutes to go in the scheduled chat time. If you have any last questios for Dr. D, now's the time. And Dr. D, if you'd like to end with any thoughts, it would be most welcome.

Mon Mar 26 2001 21:56:23 Eastern US
Skipppy (Grandmother of Brooke Perry) from 63.175.212.70
Thank you Dr. Draznin, we keep trying. She is a special little girl in our circle.

Mon Mar 26 2001 21:56:24 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
The target pulse is maintained during, after it's nice to see it return to basal in a couple of minutes or so

Mon Mar 26 2001 21:56:53 Eastern US
Connie (CO) (Marisa, 11, pumps) from 64.12.104.53
Marisa plays Competitive Volleyball-- so on tournament days she is up by 4:30, on the road at 5:30am, and warming up by 7AM. Then she plays 4-5 matches throughout the day, usually leaving the gym around 5-6PM. She was pumping velosulin for the first couple months of tournaments this year, and it was a real challenge. For the past 4 tournaments she's been back on Humalog, but it's still a "hmmm, what will work today deal." During the down time between matches she is often grazing(food) so makes it so hard to get accurate readings-- but-- we've found that she has to rely alot on "how she feels"--I can't imagine handling it if she was not on the pump.

Mon Mar 26 2001 21:57:12 Eastern US
sarah (dx'd 2.5 yrs, pump user) from 24.112.158.2
thanks so much for all the answers!!! i'm signing off, so have a great evening!!

Mon Mar 26 2001 21:57:25 Eastern US
Ellen (FL) (Zachary 13, dx'd 2/89, pump 5.5 yrs) from 152.163.213.58
Dr. Draznin, are physicians appealing to the powers that be in government to bring back phys ed as an integral part of education?

Mon Mar 26 2001 21:57:39 Eastern US
Skipppy (Grandmother of Brooke Perry) from 63.175.212.70
Dr. D. it would be nice for us, if you could chat again on other subjects to do with diabetes.

Mon Mar 26 2001 21:57:41 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
I am glad to have tried to answer questions tonight, obviously I am not a great sage, everyone is different. What is gratifying is that kids parents and the parents for themselves are active and that's good

Mon Mar 26 2001 21:58:09 Eastern US
BettyB (ChatModeraor) from 152.163.204.29
Sarah, thanks so much for joining in tonight and sharing. Night!

Mon Mar 26 2001 21:58:51 Eastern US
Moira (Lauren, 9, dx 10/97, pumping) from 24.48.181.11
Thanks Dr D and Betty B

I think that sounds like a line in a rap song

Mon Mar 26 2001 21:58:58 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
Thanks Betty and Dr Draznin

Mon Mar 26 2001 21:59:13 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
PE is sort of lower than some other things, and each state is different, put some pressure on YOUR favorite doc!

Mon Mar 26 2001 21:59:51 Eastern US
BettyB (ChatModeraor) from 152.163.204.29
Dr.D - that fact that you know how different everyone is MAKES you a great sage! LOL Too many professionals still try to give pat answers. Thanks so much for sharing your kno2ledge and caring with us tonight!

Mon Mar 26 2001 21:59:52 Eastern US
Ellen (FL) (Zachary 13, dx'd 2/89, pump 5.5 yrs) from 152.163.213.58
Do you know my favorite doc? Robin Nemery?

Mon Mar 26 2001 22:00:20 Eastern US
BettyB (ChatModeraor) from 152.163.204.29
If my typing gets any worse, I will have to go into hiding!!! LOLOL Night all!

Mon Mar 26 2001 22:00:57 Eastern US
Dr. Draznin (Chat Host) from 65.224.63.98
I am sorry not to know Dr. Nemery, thanks everyone for the chance to interact! Night

Mon Mar 26 2001 22:01:00 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
Are you low Betty??LOL

Mon Mar 26 2001 22:01:03 Eastern US
Skipppy (Grandmother of Brooke Perry) from 63.175.212.70
Thanks for the answers. See you all on here again soon. You may not be a great sage, doc, but you are a great doc.

Mon Mar 26 2001 22:02:03 Eastern US
BettyB (ChatModeraor) from 152.163.204.29
I don't think so, Connie -- I think I actually type better when I'm in the cellar! LOL

Mon Mar 26 2001 22:03:22 Eastern US
Connie(BC) (Type 1) from 207.194.24.69
bye...

Mon Mar 26 2001 22:03:23 Eastern US
BettyB (ChatModeraor) from 152.163.204.29
Room will stay open for another 20 minutes or so for those who want to finish up their conversations. Night all!



                 
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Last Updated: Thursday August 29, 2002 21:04:28
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