Exercise and type I diabetes blood glucose control
Scott Benner
Arden followed in her brother's footsteps last week when she tried out and was selected to play on our town's all star softball team. Yea Arden! The girls have been practicing each night since and I am learning more about blood glucose control before, after and during exercise then could have imagined.
First thing I learned is that all of Arden's activities from the past don't put nearly the strain on her system that an intensive two hour practice/game brings to her. Arden experienced a latent low in the early hours of the morning that followed her first practice. It was nearly eight hours since that practice began when her BG suddenly dropped. I couldn't cut off the fall by suspending her basal so I woke her up to drink a juice box. Normally I can fend off lows at night with a temp basal, this was different, a more powerful drop. I was awake and ready for it because I expected it but if I hadn't been, there is no telling how low she may have gotten.
So the next night I was ready! I kept her BG a little high before bed and didn't cover a small snack after practice. This turned out to be a winning combination. Night two went well.
On the third night I tried to mimic the success from the evening before but it turned out that a new site on her leg wasn't working the way I expected. When I combined keeping her BG a little high with a small snack and a site that wasn't up to snuff, I got a high BG that wouldn't come down easily. Hindsight has me wondering if the leg site was perhaps less effective because of the large amounts of running that she has been doing, as they normally work very well.
After I moved the OmniPod to her abdomen the next few nights went as planned, however I had to put quite a lot of effort into keeping things balanced. These last few weeks haven't just proved to me that strenuous activity can cause a low but that high BGs effect athletic performance. I noticed that if Arden's BG gets too high that her speed seems to diminish (I hope that you can share your experiences with me in the comments about this). Normally a very fast runner, Arden couldn't perform as she usually does if her BG began to rise above 220. I think that I also saw a decrease in her hand-eye coordination during this elevated period.
Last night before her first game I tried very hard to keep her BG around 100 before game time. I added carbs as the game was about to begin, a few slow acting and about 15 grams of juice. I was hoping to keep her steady without going too high during the game. I was able to do this with a lot of help from her DexCom CGM and she never went above 190 but wow was it a lot of work... though totally worth it to see her have such a good time.
This first game didn't just teach us more about type I diabetes, it also gave us our first look at Arden's competitive nature in a sporting moment that she regards as very important. Arden took this game seriously, she had fun but playing well was definitely high on her list of priorities. It goes without saying but we are very proud of Arden and the extra effort that is required for her to participate makes that pride shine just a little brighter.
Your child can definitely play sports at a competitive level with type I diabetes, that fact was never in question. All you have to do is give the moment the forethought and preparation that it requires, it'll be tough at first and you may spend a night or two battling lows but once you have a system in place it's not unlike the rest of your days with diabetes. You can do this.
Have fun out there!