Exercise

[Anchorman]

Hello everyone,

I am a Type 1 diabetic and use the Tamdem T-Slim x2 pump with Novorapid, diagnosed in 2011. I have only had the pump since June, going well but am still getting used to it. I have a query that I hope someone can help with.

One of the benefits I had anticipated from having the pump is that I could stop it giving me insulin when I wanted to exercise and that this would prevent my BGs going too low. I was previously using Tresiba as my long acting insulin and that meant I would always have to take on quite a lot of sugar before, for example, a 45 mins run.

I have tried taking the pump off entirely an hour and half before exercising (and have no insulin on board) but have found that my sugars still go very low after about 20mins of running so that I have to take on sugar to recover. Any idea why this happens when I have no insulin in my system?

Thanks

 

[SimonP78]

I don't use a pump, so someone who does may chime in and have better information.

Novorapid has an activity profile of between 3 and 5h or thereabouts, so you may find you need to stop the pump even earlier.

Alternatively, and probably better all round to avoid you going high and needing to plan so far ahead, is to have an uncovered snack shortly before you start your run. How much are you needing to eat out of interest and what does your BG profile look like?

 

[eventhorizon]

Hi.

If you're going low you must still have some IOB.

For planned exercise I'll stop the delivery of all insulin at least 2 hours before and watch my cgm until I start to see it rise steadily. Then I will restart my basal at 10 - 15% for the duration of exercise. It's not perfect but the best I've worked out.

If it's an unplanned exercise I'll have to eat some rapid action carb.

 

[Anchorman]

Thanks - the insulin on board function that is on the pump should, I think, take account of the insulin profile being >3 hours. I have it set in the pump at 5 hours. I am only starting exercise when then the IOB reading is zero.

I am needing to eat quite a lot of sugar after about 20-30 mins. Will drop from 7.0 at the start to c.3.5 in around 30 mins, so that I need to have c.40g carbs to get back up to around 6 over the next 1 hour (when walking, not running).

I will try the uncovered snack before starting and see if that works better.

 

[Anchorman]

Hi.

If you're going low you must still have some IOB.

For planned exercise I'll stop the delivery of all insulin at least 2 hours before and watch my cgm until I start to see it rise steadily. Then I will restart my basal at 10 - 15% for the duration of exercise. It's not perfect but the best I've worked out.

If it's an unplanned exercise I'll have to eat some rapid action carb.

Thanks - that is helpful. IOB reading has been zero when I start but, agree, that is unlikely to be right.

 

[In Response]

If your insulin lasts 3 hours, this includes the insulin you use for your basal. Therefore, if you remove your pump 90 minutes before starting exercise and you say you calculate that NovoRapid remains active for 3 hours, you still have 90 minutes of your basal in your body.

 

[Juicyj]

I also use the Tandem Slim and Control IQ - I have found even with no active IOB that I still go low despite using exercise mode in going for 40+ mins on a run, I now turn off Control IQ an hour before I go out and make sure my levels are above 9 mmol/l and I now barely skirt above hypo levels so will drop to around 4.5 mmol/l, I always carry glucotabs so when I see the arrow going down below 6 I just neck 3 tabs - touch wood that is working ok for me.

 

[Anchorman]

If your insulin lasts 3 hours, this includes the insulin you use for your basal. Therefore, if you remove your pump 90 minutes before starting exercise and you say you calculate that NovoRapid remains active for 3 hours, you still have 90 minutes of your basal in your body.

Thanks, agree that prior basal insulin could be a factor.

 

[Anchorman]

I also use the Tandem Slim and Control IQ - I have found even with no active IOB that I still go low despite using exercise mode in going for 40+ mins on a run, I now turn off Control IQ an hour before I go out and make sure my levels are above 9 mmol/l and I now barely skirt above hypo levels so will drop to around 4.5 mmol/l, I always carry glucotabs so when I see the arrow going down below 6 I just neck 3 tabs - touch wood that is working ok for me.

Thanks - my experience seems very similar to that. I found Exercise Mode on the pump ineffective when using Control IQ. Will try your approach.

 

[Juicyj]

Thanks - my experience seems very similar to that. I found Exercise Mode on the pump ineffective when using Control IQ. Will try your approach.

Sadly it is my only complaint with the Tandem that it can't cope with exercise mode, just remember to set an alarm reminder to turn Control IQ back on though as sometimes I forget to do this for a few hours which doesn't help ! Let me know how you get on as would be useful to see how you cope with this ?

 

[RobertJ]

Hello everyone,

I am a Type 1 diabetic and use the Tamdem T-Slim x2 pump with Novorapid, diagnosed in 2011. I have only had the pump since June, going well but am still getting used to it. I have a query that I hope someone can help with.

One of the benefits I had anticipated from having the pump is that I could stop it giving me insulin when I wanted to exercise and that this would prevent my BGs going too low. I was previously using Tresiba as my long acting insulin and that meant I would always have to take on quite a lot of sugar before, for example, a 45 mins run.

I have tried taking the pump off entirely an hour and half before exercising (and have no insulin on board) but have found that my sugars still go very low after about 20mins of running so that I have to take on sugar to recover. Any idea why this happens when I have no insulin in my system?

Thanks

Just like you, I have a Tandem T-Slim X2 and have also been on it since June.

I've found a pretty good strategy with a morning run but this may not work for you. As soon as I wake up, I set the temporary basal rate to 80% and set the time period to two hours. I think last time I did three hours, as an experiment. As long as my reading is 6 or 7, it basically ends up back there at the end of the run. It rises a bit at the start, then goes back down into range.

Recently I did a park run, adopting the same strategy. It was 7.3 just before the run began and 7.3 when I finished.

I haven't found a reliable strategy for evening runs, though. Both times I've tried that on the pump, I've gone low. The solution is probably in using a lower basal rate like 60% and perhaps having a small snack before the run.

 

[Anchorman]

Just like you, I have a Tandem T-Slim X2 and have also been on it since June.

I've found a pretty good strategy with a morning run but this may not work for you. As soon as I wake up, I set the temporary basal rate to 80% and set the time period to two hours. I think last time I did three hours, as an experiment. As long as my reading is 6 or 7, it basically ends up back there at the end of the run. It rises a bit at the start, then goes back down into range.

Recently I did a park run, adopting the same strategy. It was 7.3 just before the run began and 7.3 when I finished.

I haven't found a reliable strategy for evening runs, though. Both times I've tried that on the pump, I've gone low. The solution is probably in using a lower basal rate like 60% and perhaps having a small snack before the run.

Thanks, will report back

 

[Anchorman]

Interesting podcast on diet/ sugar hacks -link below . Worth listening too in my view as it contains quite a few new (at least to me) tips.

https://podcasts.apple.com/gb/podcast/the-diary-of-a-ceo-with-steven-bartlett/id1291423644?i=1000625634934

 

[ElenaP]

As soon as I wake up, I set the temporary basal rate to 80% and set the time period to two hours. I think last time I did three hours

How did you set up a timed temporary basal rate?

 

[RobertJ]

How did you set up a timed temporary basal rate?

I have the T-Slim X2. Do you have this as well?

 

[ElenaP]

I have the T-Slim X2. Do you have this as well?

Yes, my pump is t:slim X2. I have been using it since May last year. The manual says that, to use a Temp Rate, Control-IQ must be turned off. I was wondering if you had managed to set a Temp Rate with Control-IQ. (Temp rate was so simple with my previous pump Accu-Check Insight.)

 

[RobertJ]

Yes, my pump is t:slim X2. I have been using it since May last year. The manual says that, to use a Temp Rate, Control-IQ must be turned off. I was wondering if you had managed to set a Temp Rate with Control-IQ. (Temp rate was so simple with my previous pump Accu-Check Insight.)

I just go to Options > Activity >Temp Rate. Then you put in a percentage and how long you'd like it to be at that rate.

 

[ElenaP]

I just go to Options > Activity >Temp Rate. Then you put in a percentage and how long you'd like it to be at that rate.

I just go to Options > Activity >Temp Rate. Then you put in a percentage and how long you'd like it to be at that rate.

Thank you.