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  Back to Chat Pumping and Exercise Chat

On Wednesday, March 12, 2003, Natalie Bellini and Rick Philbin, pump trainers and pump users from Animas Corporation, hosted a chat about pumping and exercise.

Moderator  (server) Wed Mar 12 08:00:01 PM EST 2003
Our chat about Pumping and Exercise starts at 9pm Eastern.

Mike type 1 35 years (206.216.124.149) Wed Mar 12 08:07:31 PM EST 2003
how about us early birds? LOL

Lauren Pumping (24.48.182.193) Wed Mar 12 08:21:52 PM EST 2003
Hello

Mike type 1 35 years (206.216.124.149) Wed Mar 12 08:31:22 PM EST 2003
Hi

thumpystowaway Type 1 (66.215.51.250) Wed Mar 12 08:31:35 PM EST 2003
hello

Mike type 1 35 years (206.216.124.149) Wed Mar 12 08:34:19 PM EST 2003
how's it going?

thumpystowaway Type 1 (66.215.51.250) Wed Mar 12 08:38:50 PM EST 2003
alright...
waiting for chat to start I guess

Jeff Hitchcock  (216.68.227.14) Wed Mar 12 08:48:02 PM EST 2003
Chat starts in about 12 minutes ...

Moderator  (server) Wed Mar 12 08:50:01 PM EST 2003
Our chat about Pumping and Exercise starts in 10 min in the 'Pumping and Exercise' room.

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 08:50:54 PM EST 2003
Hi everyone  Grin

Mike Stoker CWD Staff (216.196.249.134) Wed Mar 12 08:52:45 PM EST 2003
Hi

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 08:54:09 PM EST 2003
Hey Mike - I like the new chat rooms! I haven't been kicked off once yet. And the emoticons are great. Razz

Mike Stoker CWD Staff (216.196.249.134) Wed Mar 12 08:56:12 PM EST 2003
Thanks  Grin

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 08:58:35 PM EST 2003
Hello All

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 08:59:43 PM EST 2003
Hi Natalie! THanks for being with us tonight to lead the discussion on pumping and exercise. Rick will be with us as well?

Judy from Ny Elissa..college senior..diabetes X 20 yrs..pump/inject (24.194.101.80) Wed Mar 12 08:59:51 PM EST 2003
hi Natalie

Lisa Type 1, and two daughters w/type 1 (68.100.95.82) Wed Mar 12 09:00:13 PM EST 2003
Hey All

Judith David, 17, diagnosed at age 2 months (65.171.1.205) Wed Mar 12 09:00:16 PM EST 2003
Hello

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:00:33 PM EST 2003
Jeff, your talk in DC was GREAT. I have gotten a lot of positive responses. Dr Leslie Plotnik and her CDE Loretta Clark at Hopkins want to be a part of the Baltimore regional conference over Labor Day.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:01:34 PM EST 2003
Rick will be on within moments. Let's get started. Who wants to start with questions

Mike 49. type 1 35 years pump 2 yrs (206.216.124.149) Wed Mar 12 09:01:42 PM EST 2003
Hi

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:01:43 PM EST 2003
Hi everyone.  Smile

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:02:03 PM EST 2003
Let's talk about Baltimore on the side tomorrow, ok? For those who don't know, CWD is holding a conference specifically on fitness and nutrition, in Baltimore (Inner Harbor) over Labor Day weekend.

Jeff Hitchcock  (216.68.227.14) Wed Mar 12 09:02:32 PM EST 2003
Thanks Natalie ... a lot of people are sharing the speech with their doctors.

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:02:48 PM EST 2003
Hi Natalie, we have a hard time with karate. Sometimes if we stop the basals 2 hours before karate and eat one hour before and only take 1/3 the insulin for the carbs, my son does fine all through class. Othertimes he goes low during class or ends up high. We can't seem to nail it more than 1/3 of the time

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:02:55 PM EST 2003
Hey everyone! Thanks for having me on your chat. Any questions on pumps and exercise?

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:03:22 PM EST 2003
Let's start with who does what for what kind of exercise now and how is it working

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:03:26 PM EST 2003
I have a question to start with.
Sam plays hockey every weekend. Sometimes tournaments; almost always 2+ hours of exercise. Instead of going low, he goes high. Adrenaline. Not crazy high like he used to be (300's), but more in the 250 range. If he doesn't correct, he stays high. If he does correct, he immediately goes in range, but crashes about 4-5 hours later. Advice?

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:03:26 PM EST 2003
Natalie, I'm going to start right in here. Just looked at "The Diabetic Athlete" by Sheri Colberg the other day. Reading about soccer, the sport in which Marissa participates, she said to disconnect the pump, then do a 50% reduction in basal rates, after having a post-exercise snack. This seems excessive to me. Your thoughts?

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:04:30 PM EST 2003
I think I would go high if I did the 50% reduction for that long. Like Laura said adrenaline makes me a little higher.

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:05:00 PM EST 2003
Brenda,
Is it working? In not there are other ways. Does Marissa want to have the pump off?

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:05:19 PM EST 2003
I find a program of reduced basals (10p.m. to 4 a.m.--about 1.1 fewer units) is ok esp. if she eats a snack.

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:05:44 PM EST 2003
Rick, Marissa prefers to wear the pump. Hey, I see she has joined us.

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:05:52 PM EST 2003
I think I would rather wear the pump. Just so that I don't have a risk of getting ketones.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:06:00 PM EST 2003
Ellen, When you are getting it right some of the time, but having wide fluctuatiions others, we need to look at the snacks and the sites and age of the site. Are you higher or lower more often?

Judy from Ny Elissa..college senior..diabetes X 20 yrs..pump/inject (24.194.101.80) Wed Mar 12 09:06:03 PM EST 2003
Elissa experiences the same thing re a high bg if she doesn't have a small bolus and snack prior to exercise

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:06:04 PM EST 2003
Hi.  Razz

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:06:37 PM EST 2003
Hi Marissa Cool

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:06:45 PM EST 2003
Marissa,
The guidelines are to start with a 50% reduction. It is better to be a little high then adjust from there.

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:07:19 PM EST 2003
It's kind of funny to hear (or see) people talking about me... Hi Ellen!

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:07:21 PM EST 2003
Hi Marissa. Do you ever have problems wearing your pump during soccer? DO you use the sport pack?

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:07:54 PM EST 2003
Well, it worked, more or less, until I had to reduce her overall basals about 2 months ago. I had her switch to the alt/sports program on Sun, then realized she'd be getting MORE insulin for a few hours! Left it that way and she was actually a little high. This was after indoor soccer. The lower rates work well with longer outdoor games and practices.

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:08:03 PM EST 2003
We talk about you all the time (just kidding!)

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:08:07 PM EST 2003
Rick, yeah I would rather be higher than lower while exercising, however I'm usually fine during the game without any reduction. The only time I do reductions are if I'm low during the game.

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:08:28 PM EST 2003
Haha! I'm sure my mom mentions me!  LOL

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:09:10 PM EST 2003
Nah, your dad mentions you more, now that you are driving!

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:09:12 PM EST 2003
Does anyone think you have to take off your pump for contact sports? There are ways to protect the pump (e.g., padding)

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:09:44 PM EST 2003
Natalie, I don't have problems wearing my pump during soccer. I do use the case and hook it on to my shorts. I don't actually know what the sports pack is.

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:09:53 PM EST 2003
Natalie, it's really about 1/3 target, 1/3 high, 1/3 low ...He doesn't quit in the middle of class if he's in target or high...but when low he obviously has to stop. Sometimes they exercise more strenuously than other times.

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:09:55 PM EST 2003
Natalie/Rick - Did you get my hockey question? It's also ok to email me tomorrow if you have thoughts about Sam.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:10:04 PM EST 2003
Laura, what does Sam do for hockey?

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:10:16 PM EST 2003
That was a nice red car your dad bought you Marissa. Wink Wink

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:10:25 PM EST 2003
Yeah when I do drive my parents freak out sometimes and scream stuff like, "STOP!" esp my mom!  Razz

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:10:44 PM EST 2003
Yeah, the real question is will I be allowed to drive it!

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:10:46 PM EST 2003
Hey Laura! How is Sam doing? Let him know I still owe him a DESA T-shirt. I did not forget. I ran out of them. I should be getting in some soon.

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:11:18 PM EST 2003
Rick/Natalie, part of the problem in recent months has been with persistent nausea, usually after soccer, so Marissa has been unable to have the post-game snack. Just means lots of frequent testing. We're working on finding out the problem (that's another story  Cry).

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:12:12 PM EST 2003
Mom, dad thinks it's just stress... hopefully we'll figure it out. It could just be IBS.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:12:30 PM EST 2003
Brend, Is it stress/ How competitive is she?

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:12:39 PM EST 2003
Sam usually starts out in range (yay Metformin!), then goes highish - around 250 - by the end of the game. If he boluses a correction, he's fine for the next hour or so. But then he crashes in about 4-5 hours. Pretty big time - I've turned his basal down by 30-40% through the night and he had a 39 at midnight. Ideas? He disconnects during hockey, tests a couple times during the match, and reconnects afterward. Hasn't found a way to wear it comfortably while playing.

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:13:07 PM EST 2003
Brenda,
What about gatorade?

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:13:36 PM EST 2003
I don't think I'm that competitive.

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:13:45 PM EST 2003
Natalie, her stomach troubles began in early Aug. and she's already been tested for celiac, had an endoscopy, takes Prilosec 2X per day, and "passed" the gastric emptying test last week. Could just be stress related to school since she started high school in late Aug.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:14:22 PM EST 2003
Has he tried a Sport Pack? He may be able to keep it on then, if not correct him only to 175 and then set a 50% decrease??!! Only an idea, not medical advice..

Judith David, 17, diagnosed at age 2 months (65.171.1.205) Wed Mar 12 09:14:45 PM EST 2003
Having bg problems here re: track practice. Dave is a hurdler, takes his pump off. As a result, he's usually high

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:14:53 PM EST 2003
How important is it for any athlete to keep well hydrated all day and night. I think most people don't drink enough liquid.

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:15:29 PM EST 2003
Laura,
How about increasing his basal rate an hour or so before? When I play basketball on Sunday morning I usually increase my rate by 10% so I am not going high

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:15:44 PM EST 2003
Rick, we started getting Powerade/Gatorade in the fall for all 3 of our soccer players. I'll have to get some when soccer practice resumes next week. And, I'd better re-program the pump to lower her basals; Marissa seems to have lows 6-10 hours after exercise.

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:16:22 PM EST 2003
Oops, I didn't know we had any. Kathryn probably drinks it all... remind me mom and I'll drink it before soccer.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:16:39 PM EST 2003
Diet coke is not a 'countable liquid' due to caffeine.

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:16:42 PM EST 2003
Judith, how long does David keep the pump off? I'm not that knowledgeable about track and field to know how much time there is between hurdles.

Lindsay 14, pumping (68.100.95.82) Wed Mar 12 09:17:25 PM EST 2003
This is not anything about basals or anything, but I have the Paradigm and was wondering what most people do while swimming. I am a competitive swimmer, spending about 3-4 hours in the water training each day. Ideas?

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:17:51 PM EST 2003
You can't count diet coke? THen we dont' drink any fluids in this house. I bet you won't let us count coffee either.

Judith David, 17, diagnosed at age 2 months (65.171.1.205) Wed Mar 12 09:18:05 PM EST 2003
For practices, it's probably off 2 hrs or so. For meets, he often is without it for 4 hrs or more - unless I catch him!

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:18:29 PM EST 2003
We have a water cooler in our house. It is $10.00 a month for spring water and it keeps us drinking t. With so many boxes and bottles of liquid, almost no one drinks enough water. 1-2 glasses at each meal and 1/2-1 in between...

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:18:32 PM EST 2003
Lindsay, I take off my pump while swimming and reconnect every hour and a half or so. You could try to do that.

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:19:10 PM EST 2003
Lindsay- you should also have snacks and juice around in case you are low!

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:19:10 PM EST 2003
I guess David needs to reconnect and do a small bolus or do a pen shot to prevent the highs. Easier said than done....

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:19:19 PM EST 2003
Too bad there isn't a short acting basal insulin we could give our kids while disconnected...I wonder who's working on that? Perhaps we could get some diluted insulin and inject a little pre-exercise when we know they will be disconnected? I know some kids take a shot of R before going out on a date etc. for several hours when they want to disconnect.

Lindsay 14, pumping (68.100.95.82) Wed Mar 12 09:19:25 PM EST 2003
But what if I can't afford to be 'hooked up' long enough to correct highs and lows during those 'water times'?

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:19:29 PM EST 2003
Ok - we'll try the higher basal an hour or so before hockey. And correct to 175. We'll try those first so we can see the effect... (and we'll be up all night testing, as usual)

Judith David, 17, diagnosed at age 2 months (65.171.1.205) Wed Mar 12 09:19:36 PM EST 2003
Exactly, Brenda....

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:19:46 PM EST 2003
Laura, caffiene dehydrates the body as well a sodium. Water is the best. Erin will put lemon and sweeten it if she is tired if H2O

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:19:47 PM EST 2003
pausing to get a glass of water Cool

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:20:25 PM EST 2003
We buy a lot of plain carbonated water and water bottles which are easy to grab...I plan to get a cooler

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:20:33 PM EST 2003
Most people do not have as much problems with low blood sugars during exercise as they do after. When you exercise, after using the fuel (mostly carbs)you eat your body turns to stored glucose (glycogen)and borrows it from the muscles and liver. If you do not pay that back the body takes it from the blood (e.g. low blood sugar). This can happen shortly after exercise to as much as 24hrs later.

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:21:00 PM EST 2003
Well, practice doing it fast I guess. You always wait to get back in and if you don't have time ask your coach if you can maybe have them wait a minute. I'm sure they'd let you so that you could have a juice box. It won't take too long.

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:21:01 PM EST 2003
I was teasing you, Natalie. We drink a ton of water in our house. And also a ton of diet coke! Rolling Eyes

Judy from Ny Elissa..college senior..diabetes X 20 yrs..pump/inject (24.194.101.80) Wed Mar 12 09:21:41 PM EST 2003
Elissa does ot have a problem giving injections when she is disconnected - sometimes it's easier than reattaching the pump

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:22:18 PM EST 2003
I usually use my pen instead of reconnecting.

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:22:21 PM EST 2003
Lindsay, do you have a pen or syringes that you use as a back-up to your pump? You could do a small shot after 2 hours or so. I don't like Marissa to go more than 90 min. disconnected.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:22:31 PM EST 2003
I tell my kids to replace 1/2 the basal hourly and then work up from there.

Lindsay 14, pumping (68.100.95.82) Wed Mar 12 09:22:55 PM EST 2003
Good Idea, Marissa. My coach isn't very complient with my D.  Mad

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:22:56 PM EST 2003
What are the best snacks to consume before 1 hour of solid vigorous exercise?

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:23:21 PM EST 2003
Does anyone know the guidelines for low and high blood sugars and exercise? What is too high and what is too low?

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:23:43 PM EST 2003
Natalie, I am not good at math (no comments, Marissa), so how would you deal with an hour where the basal rate is .7 or so?

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:24:08 PM EST 2003
I would eat fruit before juice..

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:24:48 PM EST 2003
Brenda, the first replacement is .3 the next is .4

kristi mom of Garrett13 pumper (206.148.145.85) Wed Mar 12 09:25:04 PM EST 2003
My D never does the same thing twice so we have to check frequently

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:25:12 PM EST 2003
Lindsay, just explain to him that if you don't drink your juice or correct your high you could die and it would be his fault and he would go to jail. Make it all dramatic! It'll be fun.

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:25:15 PM EST 2003
over 250 and below 80?

Lindsay 14-almost 15, pumping (68.100.95.82) Wed Mar 12 09:25:20 PM EST 2003
Brenda- yes I do. It's my coach that seems to have a problem with that. I usually use the pen to make quick corrections during practice, but that's about it.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:25:27 PM EST 2003
Brenda, or in 90 minutes replace 0.5 units

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:25:37 PM EST 2003
It's just confusing since Marissa often does her shots with a pen and it's in half units!

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:26:27 PM EST 2003
Ellen,
Something that would help give energy for the upcoming exercise. Perhaps an apple (a little fiber from the skin can help)so your levels do not go too high like it may with orange juice.

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:26:28 PM EST 2003
Mom, I could always reconnect but I just don't. I don't really know why it just seems more convenient.

Lindsay 14-almost 15, pumping (68.100.95.82) Wed Mar 12 09:26:33 PM EST 2003
lol Marissa. SOunds like you're a pro with lotsa practice at this. When I do correct with a pen or injections all the kids want to crowd around and watch, or do it for me! LOL

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:26:37 PM EST 2003
Lindsay, sounds like you need a parent or nurse to speak with the coach.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:26:59 PM EST 2003
Every 90 minutes do 0.5 for exercise that produces sweat...not boy watching..that needs full replacement of insulin

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:27:55 PM EST 2003
Yeah I know everyone like freaks out! At amusement parks people give me looks because they think I'm doing drugs! It's funny!  Razz If your coach won't listen to you definitely have your parents complain. They could get him fired you know...  Grin

Lindsay 14-almost 15, pumping (68.100.95.82) Wed Mar 12 09:27:57 PM EST 2003
I've tried the parents, the attidtude I get is "put up or shut up". Maybe a doc would be better.

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:28:07 PM EST 2003
Ellen,
Over 250 with ketones or over 300 and under 100 you should delay your exercise until you are back in range.

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:28:07 PM EST 2003
Ellen,
Over 250 with ketones or over 300 and under 100 you should delay your exercise until you are back in range.

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:28:37 PM EST 2003
Definitely try the doctor!!

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:28:41 PM EST 2003
How about exercising in the heat? Differences in what needs to be done?

Judith David, 17, diagnosed at age 2 months (65.171.1.205) Wed Mar 12 09:28:54 PM EST 2003
Our endo, who is very experienced with d and exercise, uses 300 as the upper cutoff. Don't want to exercise if ketones are present at any number.

Lindsay 14-almost 15, pumping (68.100.95.82) Wed Mar 12 09:29:12 PM EST 2003
Sounds like a plan... I won't go into the stories people make up if I try to wear my pump during practice. Eek GrinQuite funny...

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:29:20 PM EST 2003
I should have clarified that my son treats 80 with some food

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:30:01 PM EST 2003
Heat will cause BS to drop more rapidly as your body is burning calories maintaining body temp. KEEP drinking water to help...

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:30:19 PM EST 2003
I find that when I exercise in the heat, I sweat more obviously and my site falls off sometimes!

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:30:19 PM EST 2003
Ellen, I would also have Marissa treat a pre-exercise 80 with food or juice.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:31:01 PM EST 2003
Marissa, You have become quite the advocate...we are all so proud. You get 'em.

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:31:16 PM EST 2003
I have never seen my son sweat like he does in karate

Judith David, 17, diagnosed at age 2 months (65.171.1.205) Wed Mar 12 09:31:23 PM EST 2003
We see lots of high bgs at camp when the weather is hot - probably related to dehydration, as well as stress. Cold often sends the bgs down as the body tries to maintain temp

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:31:50 PM EST 2003
Alright, I'm going to bed now. Good luck Lindsay! Have some fun making it all dramatic and tell him that you could die and stuff! And if he doesn't listen, have your doctor give him a call!  Grin Good night everyone!

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:32:20 PM EST 2003
Natalie/Rick, we often have Marissa test on the way to practice/game. If she's 320 and I have no ketone strips with me, as I don't usually carry them around, do we just go by how she feels (after we check for the obvious--bubbles, site has come out, etc.)? Clearly,she'd do a correction, but I assume she'd feel awful if she had ketones.

Lindsay 14-almost 15, pumping (68.100.95.82) Wed Mar 12 09:32:28 PM EST 2003
lol... Thanks a bunch, Marissa. Bye!

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:32:30 PM EST 2003
Of course the rest of the time his only exercise is using a video game controller LOL

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:32:43 PM EST 2003
I'm also wondering about the integrity of the insulin in the heat. If you are exercising in 85 or 90 degree heat, and outside for several hours, will the insulin start to lose potency?

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:33:06 PM EST 2003
Good night Marissa - you're a shinging star.

Marissa 15, pump, dxd 2 (216.68.227.14) Wed Mar 12 09:33:06 PM EST 2003
Thanks Natalie, it just aggravates me that coaches, teachers, etc. don't listen to us and think that they know what they're talking about because "they have a relative with diabetes" even though it's type 2...but they know everything in their minds. We need to fix those types of people! Bye!  Razz

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:33:13 PM EST 2003
We see highs from extra food at camp..and lack of water...and sometimes less exercise than was actually planned..

Judith David, 17, diagnosed at age 2 months (65.171.1.205) Wed Mar 12 09:33:16 PM EST 2003
Bye Marissa  LOL

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:33:32 PM EST 2003
Laura,
Dehydration... You may confuse symtoms of low BG levels with dehydration. Performance will suffer and BG levels may drop or go high depending on how much insulin is onboard. Drink 8-10oz every 15 mins during hot weather.

Lori Mom to Nathan, 9 1/2, dx'd 9/97, MMed pump10/02 (67.248.68.79) Wed Mar 12 09:34:14 PM EST 2003
Hi guys, sorry I'm late! My first chat tonite!

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:34:18 PM EST 2003
I've seen mostly highs with Sam in hot weather.

Judith David, 17, diagnosed at age 2 months (65.171.1.205) Wed Mar 12 09:35:17 PM EST 2003
Our campers are more likely to go low from all the extra exercise, and less access to sugary foods.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:35:21 PM EST 2003
I see Humalog lose integrity faster than Novolog, but even when i lived in NC in the heat, I coulld get 2 days out of a set. And in Belize with Novolog last month I got 3 days...

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:35:41 PM EST 2003
Does anyone use Mastisol to keep sets in?

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:35:46 PM EST 2003
Maybe they need more access to sugary foods Judith?

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:36:18 PM EST 2003
Laura,
It is probably due to the stress from the heat which the body then signals the liver to produce glucose.

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:36:27 PM EST 2003
We use a bit if the site tape starts to come up

Judith David, 17, diagnosed at age 2 months (65.171.1.205) Wed Mar 12 09:36:31 PM EST 2003
One of the aims of camp is to teach healthful eating habits.....

Tim Dad of Sara (67.224.56.229) Wed Mar 12 09:36:40 PM EST 2003
Yes we Mastisol

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:36:57 PM EST 2003
Rick - Will the metformin suppress this? It acts on the liver to suppress release of glucose.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:37:14 PM EST 2003
Hi Lori,
What type of exercise does your family do

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:37:37 PM EST 2003
Well better to prevent LOWS

kristi mom of Garrett13 pumper (206.148.145.85) Wed Mar 12 09:38:01 PM EST 2003
Laura why is he using the Metformin?

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:38:04 PM EST 2003
Laura, it does so consistently so the liver will 'override' it if it needs to fix a problem..

Lori Mom to Nathan, 9 1/2, dx'd 9/97, MMed pump10/02 (67.248.68.79) Wed Mar 12 09:39:06 PM EST 2003
Nathan is just a super active child--playing in the neighborhood, at youth groups, etc. We're not on any organized teams. We mostly do family sports, like tennis, golf, and archery. Watch out, Nathan says his goal is to be on the US Olympic Archery Team. Knowing him, he'll do it! Have you all talked about salt water (ocean) and how it affects the pump sites?

kristi mom of Garrett13 pumper (206.148.145.85) Wed Mar 12 09:39:13 PM EST 2003
What is the best thing to do for a kid who is starting track and will be running out on the streets far away from the school.

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:39:16 PM EST 2003
I think there are times kids with diabetes NEED simple sugars to quickly raise bg during high activity. Of course the protein and fat helps to sustain it

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:39:31 PM EST 2003
But the liver won't produce glucose in response to a low - that's one of the dangers of the metformin, and one of the reasons we have to be extra vigilant at night now. Low is low is low, Sam's body won't compensate and release glucose to bring him back up.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:39:59 PM EST 2003
Kristi, doctor Jeff and Dr Natalie suggested it

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:41:06 PM EST 2003
Wow, the metformin suppresses the counter-regulatory mechanism? That's a big down side to the medication.

Judith David, 17, diagnosed at age 2 months (65.171.1.205) Wed Mar 12 09:42:21 PM EST 2003
Kristi, be sure he's wearing medical ID, runs with others, and has fast carb with him.

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:42:58 PM EST 2003
Yes, it's scary. Dr. Hebdon warned us to be very cautious. We spent the first month testing 2-3 times/night until we got the feel of the meds. Now, Sam will turn down his basal rate by 10-30% depending upon what his bedtime bg is and the exercise he's had. Still... I caught a 39 at midnight last week.  Frown

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:43:06 PM EST 2003
Metformin does so, but not entirely. You have to be more viligent with lows, but you will get some response still, just not as quick/strong, but the positives far outweigh the negatives...What does Sam think ?

Judith David, 17, diagnosed at age 2 months (65.171.1.205) Wed Mar 12 09:43:07 PM EST 2003
It's also important that you and/or the coach know the route the kids are taking, and approx when they are due back. My son is in track, and my Russian boy ran cross country.

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:44:19 PM EST 2003
Sam loves it. A1c of 7.0, down from 7.6 and 7.9 before, and a 15% decrease in TDD. And best of all - no sustained highs anymore. He feels so much better - it's incredible. And he looks wonderful.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:44:21 PM EST 2003
Kristi he needs a BS monitor at all times. Our collegue Bill King who is a marathoner has a velcro strap for his and it is on his wrist..

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:44:23 PM EST 2003
Kristi,
The safest thing is to run with someone who knows how to handle glucagon. The obvious is to carry fast acting carbs with you but checking one hour before the run and one half hour before so you can compare the numbers. 140 1hr prior - 70 1/2hr prior. Need to eat something and maybe ajust basal rate down some.

Judith David, 17, diagnosed at age 2 months (65.171.1.205) Wed Mar 12 09:44:24 PM EST 2003
Kristi, be certain that his coach and teammates know about his diabetes, know his signs of lows and how to help him.

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:45:45 PM EST 2003
Laura,
Ask Sam if he wants a rematch in football with Natalie and me.

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:45:49 PM EST 2003
That's great to hear Laura...I didn't realize it could make such a difference

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:46:22 PM EST 2003
What exercise issues would anyone as parents/kids want addressed at future conferences?

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:46:41 PM EST 2003
Huge difference, Ellen. Also in terms of food consumption - I guess in a lot of people it can cause GI side effects. Not for Sam; but it has decreased his appetite, so he's growing and holding his weight nice and steady... and he looks just great.

Judith David, 17, diagnosed at age 2 months (65.171.1.205) Wed Mar 12 09:46:54 PM EST 2003
Kristi, I'm not sure about your son, but I know mine would not wear a meter, Do need to urge that he carries glucose tabs or gel.

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:46:54 PM EST 2003
Does anyone know why we get high blood sugars during or immediately after exercise?

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:47:10 PM EST 2003
Rick, he'll beat you up this time! I think he's taller than you now. Wink

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:47:46 PM EST 2003
I thought the highs were adrenaline induced...

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:48:08 PM EST 2003
adrenaline?

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:48:12 PM EST 2003
Laura,
Tell him to bring his "A" game!

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:48:24 PM EST 2003
AARRGGHH, our kids start school BEFORE Labor Day so we won't be coming to B'more for the Conference. We might come earlier in Aug, visit my family and friends, go to O.C., Hershey, PA, etc. That'll help Marissa get some driving hours (she needs 50 to get her license in Sep).

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:48:43 PM EST 2003
I ay adrenaline, too.

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:49:24 PM EST 2003
I'l have to get your home number, Natalie, in case we have any problems.  Grin

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:49:36 PM EST 2003
Brenda, come to Animas headquarters in Philly. Marissa can have a tour..

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:49:46 PM EST 2003
Our kids start before Labor Day, too. But we get Friday off and Monday off. So we'll fly out Thurs. Can't you come out Friday afternoon? The sessions don't start until Saturday morning. And then you have Monday off... Carolyn and Marissa can drive around together...

Jeff Hitchcock  (216.68.227.14) Wed Mar 12 09:50:34 PM EST 2003
Carolyn and Marissa driving together ...  Eek

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:50:52 PM EST 2003
They can parallel park with me

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:51:11 PM EST 2003
You weren't supposed to hear that. I thought you signed off!

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:51:12 PM EST 2003
They don't have off Fri. and we used up our frequent flyer miles when my dad died last month. Cry Too far to drive.

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:51:20 PM EST 2003
The body can recognize the exercise as "stress" and similar to a "dawn" rise in blood sugar-cortisol, adrenaline, growth hormone will be secreted telling the liver to spit out more glucose:( Result 300+ sugar.

Jeff Hitchcock  (216.68.227.14) Wed Mar 12 09:51:27 PM EST 2003
I just popped back in ...

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:51:36 PM EST 2003
Our kids start the new school year in mid August.

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:51:40 PM EST 2003
Talk about adrenaline and high bg! Add high blood pressure to boot!

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:52:21 PM EST 2003
I can get to Cleveland from Baltimore in 6.5 hours...

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:52:21 PM EST 2003
Ellen, has Z. started driving?

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:52:44 PM EST 2003
Growth hormone is secreted during exercise? Seriously?

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:52:48 PM EST 2003
Yes, but Cincinnati to Baltimore is about 10 hrs.

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:53:04 PM EST 2003
Next question... Should you correct a 300 blood sugar if you are concerned about a "lag" effect hours after?

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:53:22 PM EST 2003
 Frown

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:53:28 PM EST 2003
Natalie, you'll have to work on Brenda and Marissa. They need to come. Or maybe just Marissa and Jeff in that little red sports car. I'm SURE it can make it to Baltimore in 6.5 hours!

Jeff Hitchcock  (216.68.227.14) Wed Mar 12 09:53:54 PM EST 2003
I'd be tempted to drive there in my car

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:54:24 PM EST 2003
Rick, I think it depends on the intensity of the exercise and whether or not a post-exercise snack was eaten. In a "standard" soccer game, no snack, I'd have Marissa bolus 1.5, instead of 2.2, her usual correction for a 300.

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:54:38 PM EST 2003
Not driving yet - he's willing to wait until he takes Driver's Ed next school year Cool

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:54:41 PM EST 2003
Rick, that was my question earlier about Sam and hockey. Yes, we would correct a 300 because otherwise he'd feel really crummy for several hours. It wouldn't come down itself.

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 09:55:07 PM EST 2003
I was looking forward to Brenda driving the Harley in black leather to the next event!

kristi mom of Garrett13 pumper (206.148.145.85) Wed Mar 12 09:55:22 PM EST 2003
Yes we would correct but would have to check in 2 hours to see where we were should check Ketones also

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:55:39 PM EST 2003
She can drive the Harley to San Antonio!

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:55:48 PM EST 2003
Ellen, we don't have Driver's Ed in school. Marissa takes a class starting next Mon., 4 hrs. per night, 6 nights, then 8 hours driving.

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:56:08 PM EST 2003
The Harley doesn't live here anymore!

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:56:22 PM EST 2003
We've never had sports-induced ketones. Only illness-induced (and the initial dx ketones). Does this happen frequently?

Jeff Hitchcock  (216.68.227.14) Wed Mar 12 09:56:27 PM EST 2003
There's no more Harley ...

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:56:52 PM EST 2003
Good answers. On a pump you can correct and then either set a temp basal for the lag time low coming hours later or check more often and treat if you get a low.

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:57:03 PM EST 2003
I wouldn't expect ketones, either, unless Marissa had disconnected, intentionally or not.

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:57:21 PM EST 2003
Brenda,
Most clinicians will discourage correcting a high blood sugar for fear of overcompensating (strike 1)and then dealing with the lag effect (strike 2). It is risk/reward thing... I personally will correct and check within a 1/2hr after to see if it is coming down. Once in range then I will take a snack.

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 09:57:21 PM EST 2003
Brenda,
Most clinicians will discourage correcting a high blood sugar for fear of overcompensating (strike 1)and then dealing with the lag effect (strike 2). It is risk/reward thing... I personally will correct and check within a 1/2hr after to see if it is coming down. Once in range then I will take a snack.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 09:57:49 PM EST 2003
Marissa would love to bike..Good thing you got rid of it...interesting timing..

Lori Mom to Nathan, 9 1/2, dx'd 9/97, MMed pump10/02 (67.248.68.79) Wed Mar 12 09:58:04 PM EST 2003
Rick, would you then bolus the snack?

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 09:59:26 PM EST 2003
Lori, I don't know Rick's answer, but mine would be to "underbolus." Instead of 1 per 15g, I'd have Marissa bolus .7 at most for 15g and also suggest a higher fat snack.

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 09:59:59 PM EST 2003
Ditto what Brenda said about the snack bolus.

Lori Mom to Nathan, 9 1/2, dx'd 9/97, MMed pump10/02 (67.248.68.79) Wed Mar 12 10:00:36 PM EST 2003
Brenda, so you're doing 70% of the normal bolus if you're in that "don't know if I have a lag time low coming on" period?

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 10:00:41 PM EST 2003
Rick if you check 1/2 hour after bolusing and discover it's not coming down - then what do YOU do?

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 10:01:21 PM EST 2003
Laura,
You can have sports induced ketones (but not as likely) the problem is most people do not take the time to see whether they have them or not. I am sure they do get them.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 10:01:50 PM EST 2003
Brenda, you are right on..

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 10:01:55 PM EST 2003
Lori, I guess so. I just keep my fingers crossed, get no sleep and test a lot.

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 10:02:04 PM EST 2003
We wait. Don't bolus again. Sometimes it takes Sam's bolus a good 2 hours to really work. I don't know why, but it can take that long for him. It's frustrating, though... if we did a second bolus, he'd crash crash crash...

Lori Mom to Nathan, 9 1/2, dx'd 9/97, MMed pump10/02 (67.248.68.79) Wed Mar 12 10:03:54 PM EST 2003
Here's a Q: since we don't do organized sports, just UNorganized ones (!) with neighbor kids, I can't reduce my basal rate an hour ahead of time (what our CDE recommended in our pump class). Some days kids ring the bell after school and want Nathan to come out and play (they play HARD) for 30-60 minutes, but sometimes no one comes over (too cold, too much homework, etc.) So I test before he goes out, and if he's in range, I give a couple shortbread cookies (about 10 g. carbs) or a graham cracker. But I'm still a wreck the whole time he's gone. What about those unexpected high level activities? What do you all do?

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 10:04:10 PM EST 2003
I'm with you Laura, we wait hours to make sure it's working...especially to bring down a very high high...takes much longer

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 10:04:18 PM EST 2003
But Rick, as an adult, you can do that. Kids are a little more tricky. I wait an hour and then make a decision. I think that kids are tricky..

Laura B CWD events, Sam's mom, 12, dx'd 8/98 (68.43.235.39) Wed Mar 12 10:04:18 PM EST 2003
I'm morphing into a pumpkin - it's bedtime here! What do I bolus for that? Rick and Natalie, thank you so much for being with us tonight. This chat room will stay open for another half hour or so, so everyone feel free to stay and chat for awhile! G'night!

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 10:04:48 PM EST 2003
Marissa went ice skating Sat. afternoon and ran low most of the evening, pigging out like crazy. Despite my warnings, she kept eating away, trying to bolus some, too. From 12 to 5:30 a.m. I gave her 3 boluses and couldn't get her below 290. Finally exhausted and frusted, I bolused .3 and did a 1.5 unit injection, 90 min. after a 1.5 bolus. She was really ticked off when she woke up at 8:30, BG only 42! OOOPS, I goofed. Guess that last .3 was too much.

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 10:05:06 PM EST 2003
Ellen,
I will correct my normal correction factor and then if it is not coming down I will check my site and then give half as much as my normal correction. I do want to eat when I get into range to replenish stores whether I have diabetes or not.

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 10:07:47 PM EST 2003
Do you find most parents of pumpers are dedicated to getting optimum results in their kids, or do you find most just think you stick on the pump and that's all there is to it? Are we the norm here in this room?

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 10:07:50 PM EST 2003
Other questions?

Lori Mom to Nathan, 9 1/2, dx'd 9/97, MMed pump10/02 (67.248.68.79) Wed Mar 12 10:08:22 PM EST 2003
Brenda, we're new pumpers, so I don't really know if this is a "good thing" to do, but when I've got a stubborn nighttime low and I'm sure it's from overeating at evening/nighttime, I'll do a temp. basal increase of 0.1 for an hour or two along with the correction for the high. It has always worked for Nathan, but if I remember, you're dealing with a teen, right? I know their BG's are trickier than a 9 year old's!

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 10:08:23 PM EST 2003
Lori, I think that providing an extra snack with or without a small bolus (depends on the amount of carbs) is probably the best answer. I didn't think of it when Marissa ran outside to play soccer in our yard before dinner. So far, she hasn't gone low, but she did say she ate a Caramello bar around 2:30. Must've still been in her system.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 10:09:29 PM EST 2003
Parents associated with CWD are definately a special group, but all parents try to their best ability to get optimal results in their kids...some have other hurdles to jump along with D that are as big or bigger that get in the way.

Jeff Hitchcock  (216.68.227.14) Wed Mar 12 10:09:40 PM EST 2003
Natalie and Rick, thanks for taking the time to share your wisdom and experience with us tonight.

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 10:09:48 PM EST 2003
Lori, it was just one of those things; it had never happened before and drove me nuts! I think I had done a temp. increase and it still didn't help.

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 10:09:59 PM EST 2003
So most parents of pumpers are not sleeping at night? arg

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 10:10:37 PM EST 2003
Jeff and Laura,
Thanks for having us on. I would love to do it again.

Lori Mom to Nathan, 9 1/2, dx'd 9/97, MMed pump10/02 (67.248.68.79) Wed Mar 12 10:10:43 PM EST 2003
Natalie, anything about salt/ocean water being different on the plastic parts of the site than pool water? This will be our first summer on a pump, and we may head down to FL at some point.

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 10:11:01 PM EST 2003
I'm not, Ellen. LOL I would like to get back into no more than 2 tests per night, but now that Spring is around the corner, and soccer season, I'm not sure much will change.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 10:11:45 PM EST 2003
Most parents of kids with D that a striving for near-normal numbers are not sleeping. 70-120 is very close to 26 mg/dl. Parents whose kids run 120-200 have less to worry about...

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 10:12:03 PM EST 2003
Lori, post a ? on the parents mailing list. I would like to know this as well. I have a vague recollection of Sharon S. discussing Steven at the beach.

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 10:12:05 PM EST 2003
I'll second the thanks! It's so great to be able to ask questions without having to call the ped endo or wait until the next office visit. (even though our endo is awesome)

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 10:12:49 PM EST 2003
All water will effect the sites. I used Mastisol in Belize for a week and it was great...Catheters stayed in for a record 3 days while in the ocean as much as the fish

Brenda H. mom of Marissa, 15.5, dx'd 9/89 (216.68.227.14) Wed Mar 12 10:13:00 PM EST 2003
Thanks for all the tips, Rick and Natalie. See you next time.....

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 10:13:11 PM EST 2003
My friend's son has been on the Animas for years and goes snorkeling in the salt water with it on without problems

kristi mom of Garrett13 pumper (206.148.145.85) Wed Mar 12 10:13:42 PM EST 2003
All they ever tell us about exercise is just experiment. By the end of the season we finally get a little system going

Ellen (FL) Zack 15, dx'd 2/89, pump (205.188.209.101) Wed Mar 12 10:14:18 PM EST 2003
Kristi, so much of managing diabetes is trial and error.

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 10:14:25 PM EST 2003
Lori, come to Florida in July to the conference. You will be so glad you timed a visit when we are all there. I tought more around the pools than in the classroom and there are so many experts...

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 10:15:09 PM EST 2003
We should do a talk on catheters..

Lori Mom to Nathan, 9 1/2, dx'd 9/97, MMed pump10/02 (67.248.68.79) Wed Mar 12 10:16:30 PM EST 2003
I will try to get down there for it!

Natalie Bellini RN, CDE Nurse Educator, Person wth Diabetes, Pumper (66.7.139.98) Wed Mar 12 10:16:33 PM EST 2003
I need to sleep. Thanks for coming to all of you. Keep up the great work. Rick and I hope to see you in Orlando and Baltimore. Good night

Rick Philbin, MED, ATC, CSCS Pump User, Certified Athletic Trainer, Certified Strength & Conditioning Specialist (64.80.216.114) Wed Mar 12 10:16:45 PM EST 2003
Thanks everyone... I hope to get online with you again. Hopefully I will meet you in Orlando or Balt. CWD conference

Lori Mom to Nathan, 9 1/2, dx'd 9/97, MMed pump10/02 (67.248.68.79) Wed Mar 12 10:17:45 PM EST 2003
Goodnight



                 
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