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Insulin pump and exercise
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<blockquote data-quote="dowuchyalike" data-source="post: 297623" data-attributes="member: 32924"><p>Hi Chris</p><p></p><p>There are lot of variables involved, so unfortunately I don't think there's a one-size fits all approach to pump therapy and exercise, however, this is the great thing about the pump, that it allows the kind of flexibility that basal-bolus injection regimes can never provide.</p><p></p><p>There is a lot of trial and error involved and you need do to consider whether your exercise on the day is going to be predominantly aerobic or anaerobic as this will greatly influence your strategy. The duration of the session is also relevant. Testing before, during, and after your workout is essential in my opinion.</p><p></p><p>For myself, I largely train intensely/anaerobically and find that my blood sugar often goes up during the workout or just after it, so I keep the pump on, keep a close eye on things and am always ready to bolus if necessary. Once my blood sugar is down to a reasonable level post-exercise I will reduce my basal rate to 80% for anything up to 12 hours (sometimes longer depending on how hard I trained) because muscles continue to draw glucose from the blood to replace glycogen stores long after the exercise has ended.</p><p></p><p>If I train aerobically, I'll test well beforehand and make a decision based on the result. The danger of reducing your basal rate too much before the session is that you might not have the insulin on board to provide your cells with the energy that they need during the activity, so it's a fine balance. If the activity is not going to last longer than 30 minutes and my sugar level is around 8 or 9mmol, I find just removing the pump 30 minutes before and leaving it off until I'm finished is sufficient to keep things stable. Again, I always keep my monitor handy and often test in the middle of the session just to see what's going on. Post-aerobic activity, I don't find the same need to reduce basal rates as severely and will generally just knock it down to 90% for about four hours but review my blood sugar at the end of that period and modify the rate again if necessary.</p><p></p><p>Can't stress how much this is something that you're going to have to experiment with because it's taken me a good while to find the right solution and even now I can get it wrong sometimes.</p><p></p><p>Best of luck.</p></blockquote><p></p>
[QUOTE="dowuchyalike, post: 297623, member: 32924"] Hi Chris There are lot of variables involved, so unfortunately I don't think there's a one-size fits all approach to pump therapy and exercise, however, this is the great thing about the pump, that it allows the kind of flexibility that basal-bolus injection regimes can never provide. There is a lot of trial and error involved and you need do to consider whether your exercise on the day is going to be predominantly aerobic or anaerobic as this will greatly influence your strategy. The duration of the session is also relevant. Testing before, during, and after your workout is essential in my opinion. For myself, I largely train intensely/anaerobically and find that my blood sugar often goes up during the workout or just after it, so I keep the pump on, keep a close eye on things and am always ready to bolus if necessary. Once my blood sugar is down to a reasonable level post-exercise I will reduce my basal rate to 80% for anything up to 12 hours (sometimes longer depending on how hard I trained) because muscles continue to draw glucose from the blood to replace glycogen stores long after the exercise has ended. If I train aerobically, I'll test well beforehand and make a decision based on the result. The danger of reducing your basal rate too much before the session is that you might not have the insulin on board to provide your cells with the energy that they need during the activity, so it's a fine balance. If the activity is not going to last longer than 30 minutes and my sugar level is around 8 or 9mmol, I find just removing the pump 30 minutes before and leaving it off until I'm finished is sufficient to keep things stable. Again, I always keep my monitor handy and often test in the middle of the session just to see what's going on. Post-aerobic activity, I don't find the same need to reduce basal rates as severely and will generally just knock it down to 90% for about four hours but review my blood sugar at the end of that period and modify the rate again if necessary. Can't stress how much this is something that you're going to have to experiment with because it's taken me a good while to find the right solution and even now I can get it wrong sometimes. Best of luck. [/QUOTE]
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