Pumping, swimming and TBRs

[vans]

Hi all
I'm on the omnipod and have recently starting swimming. I'm finding it really hard to manage BG around this. I've tried setting TBR, reducing previous meal bolus and snacking before / after...

If you swim, how do you manage your BG?

Thanks in advance

 

[azure]

Hi @vans I have a Vibe (waterproof) but I just disconnect it as I find I don't need any insulin to swim. I also test and eat glucose tablets if necessary before and during my swim.

I'm lucky in that my BS doesn't go up and I can leave my pump off for a couple of hours (not all swimming, some travelling).

 

[Juicyj]

Hi all
I'm on the omnipod and have recently starting swimming. I'm finding it really hard to manage BG around this. I've tried setting TBR, reducing previous meal bolus and snacking before / after...

If you swim, how do you manage your BG?

Thanks in advance

Hi Vans - what type of issues are you getting ?

Same as Azure I disconnect before I swim, mines not waterproof so no choice it has to come off and I tend to leave it off for around half an hour afterwards, I only swim for 40 mins and as long as my BG level is above 6/7 I don't have an issue if lower I have some jelly babies before I get in, I always leave my kit and glucose with an attendant or at the side of the pool just in case.

 

[Medusa41]

Hi @vans - I do the same - disconnect it & am only in the water for around 45 mins. Occasionally I'm slightly high after so I just bolus a little. HTH

 

[ann34+]

Hi all
I'm on the omnipod and have recently starting swimming. I'm finding it really hard to manage BG around this. I've tried setting TBR, reducing previous meal bolus and snacking before / after...

If you swim, how do you manage your BG?

Thanks in advance

How do you mean , 'really hard' - hypos? highs? up and down? night hypos? i thought the pump might make things easier. I could not manage swimming on injections, i tried for years, and had various unpleasant experiences including terrible night hypos and one pass out in the water, stopped as too dangerous. On pump for ages now and i have recently thought i may try again . i may do what i used to do - have a lot of carbs at first and judge what i need now, playing safe to start. The thing is, years ago, i was younger and fitter, and, despite always using relatively little daily insulin, and less on a swim day, and having up to 70 carbs extra for 15-20 mins, and more in a break for longer, and eating more carbs before sleep, things were impossible - swimming had to stop - i know things are unlikely to be the same now, as i am older and with a pump, interested in your experiences.

 

[tigger]

I swim. I do a temp basal before, then disconnect as mine is not waterproof and swim for about 30 mins. I then add a tiny bit for basal and do temp basal after. I don't think I swim as energetically as when I do zumba though. Zumba I have to be above 9 and do a 50% tbr. or I crash badly. Swimming I can usually manage with 70%.

 

[vans]

Thanks all, that's really useful. I think part of the issue is I have the Omnipod so can't disconnect!
Will write more when I'm not at work! Cheers

 

[tircoed]

Im on a Omnipod and u can suspend but i only usually do this when changing basal/bolus setting not sure if this would work for swimming

 

[catapillar]

Thanks all, that's really useful. I think part of the issue is I have the Omnipod so can't disconnect!
Will write more when I'm not at work! Cheers

You can suspend insulin delivery entirely and still leave the pod on. Or you can do a TBR of -95%. If you're having problems going low during your swim you're best off starting a significantly reduced temp basal at least 2 hours before you start swimming. Make sure you've got no IOB when you start swimming and you might want to have some uncovered long acting carbs.

 

[vans]

@ann34+ @Juicyj
So by 'really hard' I mean that I'm just not sure what I should do! Set a TBR? Reduce bolus on previous meal if swimming within 2 hours? Both?

I think part of the problem is remembering to set the TBR when I'm going to swim. I'm quite new to swimming (and exercising to be honest!) so I'm often not setting the TBR until 1 hour or less before swimming.

I was going quite high during/after swim, that was on TBR of -45% for 4 hours so I guess that's too much. Today I tried -15% for 4 hours, was 10.4 before and 4.0 after a 25 minute swim so had a few jelly babies and that seemed to level me off.

I guess the hardest thing is working out how long it affects me for and how to counteract that. Once I've worked all that out, then I can address the pilates workout and how that affects me but that's a whole other thread!

Basically...screw diabetes...it makes life so complicated! I think I'm suffering burnout after 12 years and it's so hard to manage. That too is a whole other thread

Thanks for reading and for your advice all. It's really appreciated

 

[vans]

You can suspend insulin delivery entirely and still leave the pod on. Or you can do a TBR of -95%. If you're having problems going low during your swim you're best off starting a significantly reduced temp basal at least 2 hours before you start swimming. Make sure you've got no IOB when you start swimming and you might want to have some uncovered long acting carbs.

Thanks Catapillar. That's helpful

 

[ann34+]

@ann34+ @Juicyj
So by 'really hard' I mean that I'm just not sure what I should do! Set a TBR? Reduce bolus on previous meal if swimming within 2 hours? Both?

I think part of the problem is remembering to set the TBR when I'm going to swim. I'm quite new to swimming (and exercising to be honest!) so I'm often not setting the TBR until 1 hour or less before swimming.

I was going quite high during/after swim, that was on TBR of -45% for 4 hours so I guess that's too much. Today I tried -15% for 4 hours, was 10.4 before and 4.0 after a 25 minute swim so had a few jelly babies and that seemed to level me off.

I guess the hardest thing is working out how long it affects me for and how to counteract that. Once I've worked all that out, then I can address the pilates workout and how that affects me but that's a whole other thread!

Basically...screw diabetes...it makes life so complicated! I think I'm suffering burnout after 12 years and it's so hard to manage. That too is a whole other thread

Thanks for reading and for your advice all. It's really appreciated

Hi, vans, not sure whether you are a woman or man. For women there is, or i found there was for me, the added problem re insulin sensitivity changes through a month - just had to avoid a lot of times as too dangerous.
Re the TBR now i am on the pump exercise is still a problem, though less so - but even for a short walk i will halve the BR about 30 mins before i leave, but still have carbs as well, and still may go a little hypo if not very careful. i imagine each person is different.
Though i do not swim now, my general advice would be never to get near 4.0 even at the end of a swim.... 8.0 would be much better - you can always sort things safely later and might go on going down. When i passed out in pool i had tested first, and had had carbs first, and had not swum more than 15 mins, so on the face of it i should have been safe - if it had not been a nearly empty pool so i was seen immediately by all 3 lifeguards, who dived to rescue me (i have no memory of this at all and came to on the wet cold edge of the pool, with an ambulance man looking down at me ) i would not be here now. .......there is a good post by fletchweb in thread New study/handbook on exercise for Type ones. keep safe

 

[vans]

Cheers @ann34+
I am a woman 46 years old and I've never really noticed much difference in sensitivity during my cycle but I think I may do now. Can you point me to any guidance? Do women tend to need more or less during menstruation?
Had a couple more successful swims now with a TBR of around -20% and keeping BG up around 10 for the duration of the swim. Will check out fletchweb's post
Thanks all

 

[ann34+]

Cheers @ann34+
I am a woman 46 years old and I've never really noticed much difference in sensitivity during my cycle but I think I may do now. Can you point me to any guidance? Do women tend to need more or less during menstruation?
Had a couple more successful swims now with a TBR of around -20% and keeping BG up around 10 for the duration of the swim. Will check out fletchweb's post
Thanks all

Hi, vans, fletchweb's post is in the Research section - New Study /handbook on exercise for Type 1s . It's good to hear that you have had some successful swims on the pump. As mentioned, i never had the opportunity to swim with a pump when i was younger - it may be a lot easier, but 10 seems safer to me than much lower. The problems for many Type ones, as the study mentions, may be the 24+ hours after exercise - though you may be lucky and not find many, like fletchweb . Re guidance re monthly changes, i am afraid i have little general info - one female consultant told me that she had no answer either, as every woman was different, and that one can only try to understand one's own patterns. In my case the pattern was rather complex, but overall the most insulin sensitive time was mid cycle, and the least sensitive was the end of the month/beginning of next cycle. If you have not noticed many changes previously, maybe hormones are now altering a bit nearer the perimenopause? If so, then there may not be a pattern, i am not sure....maybe your clinic can help? Hope things work out - i hope to try swimming again soon.

 

[Codythechef]

I am the same as many above^ if I go swimming I take my Medtronic 640g off as it is perfectly safe to do so for an hour or so (if any longer check bg after and correct obvs).

 

[vans]

Thanks all. Well I just had a long meeting with my DSN and the Consultant who are both lovely at Bristol Royal Infirmary. I was there for an hour 45 minutes and we talked about lots of different stuff.
One thing I didn't know was that fast, intense swimming is anaerobic and this can actually increase your BG! I had no idea

So I will continue to swim and to test and try different things...hopefully I will eventually get there!