Anyone have experience with college athletics and T1D?

Type 1 & LADA T1 Teen/College
21

@mlg
A couple other things to mention, maybe your son is already doing this stuff.

While the trends of Dexcom can be useful, I find the delay between what it shows and my actual BG at that moment to be very impractical during exercise. Dexcom is always a few miles behind. For your son, it might be a few innings behind.

A BG test with a quality meter during every at-bat inning would be extremely useful. And he can look at the change from one inning to the next in the same way you can look at a CGM slope.

I used to use sugar packets with soccer, because if you fall on them it doesn’t cause a problem. Possibly something like that would be useful for when he is out on the field. I think it is better than a hard container of candy or gtabs in your pocket if you land on it. 1 packet has about 4 grams.

I think you said he is a pitcher? That is ideal because he controls the pace of the game. He can take a bit of sugar between batters, everyone is forced to wait for him. He can kick dirt on the mound and adjust his hat or whatever it takes to give him a few moments to take sugar if needed.

Keep in mind a pod can fall off if you land on it. I don’t think you want to fill and activate a pod during a game. He probably already has this, but having a spare pen of insulin in his bag would be a good idea.

I like Gatorade Prime for quick sugar corrections because it is more concentrated than normal Gatorade, and a small sip can give you a very quick boost. They have it on Amazon. It comes in 4 ounce pouches, so he could have a few in his bag for when he is in the dugout.

Strip management for BG meters is the trick. I sent a few strip holders to some people here. They hold strips securely, but allow you to take them out one-at-a-time, even when wearing gloves. It’s much easier than opening a strip vial and spilling them all over. Strips do not fall out of this holder! I use it all the time, every run, and I think it is great. But that’s just my opinion, ask @Michel, @Chris, @ClaudnDaye, @sam, if they are useful for them for different activities.

Here it is
strip-holder

If you want, I can make one for you on my next batch.

4 Likes
22

Sugar packets were all I used for lows in elementary and high school. Word of advice: check pockets before doing laundry.

4 Likes
23

Kaelan LOVES these when he goes running! Thanks again, @Eric!

3 Likes
24

We use them religiously! :slight_smile: Nothing better than wanting 1 strip and actually getting 1 strip. <3

3 Likes
25

I’d also be open to giving it several tries, if it doesn’t work the first time, as so much is about trial and error. You can check out @daisymae’s swimming thread to see how she evolved from starting her swims at 200 and dropping like a stone, to jumping in the pool with a BG of 100 and staying steady over a 2 hour swim without post-exercise lows… it took many, many tries but eventually she cracked a formula that worked very well for her.

All that is to say @Eric has really fabulous advice, but that doesn’t necessarily mean it will work right out of the box, so to speak. You have to do a lot of experimenting to figure out the right number of carbs, the right timing, the amount of insulin, and how this basic formula varies with other lifestyle factors.

2 Likes
26

All great tips @Eric! We mostly use the Dexcom to watch his trends and never let it get too low during a game. So if he is pitching in his 4th inning and he is in the 100s and trending down, we will get him a snack between innings. There are a couple of MLB pitchers that check bg every inning in dugout and that would be ideal, but my son is not at that maturity level yet. I think it is also awkward for him in some situations to be checking. High school is hard enough and then you add the responsibilities that go with diabetes. I see him come off the mound and into the dugout and all his team mates and coaches talking to him. He just doesn’t always have the self discipline yet to walk away from that and go check his bg. I usually have to tell him he needs a snack. This will be a goal this spring to get him to start to check during games more himself. He does not actually take any glucose sources onto the playing field with him. He just waits between innings. He has only once in 9 years actually been low on the field and had to sit out an at bat.

The strip holder is awesome! You make those? What a great idea.

1 Like
27

You mentioned being just outside of Boston—I don’t know if you’re already at Joslin, but I bet they have people (endos, CDEs, etc) with experience dealing with exactly this sort of issue.

28

@TiaG I agree. So much of this is trial and error and dependent on the individual. There are so many variables. Thank you for mentioning the swimming thread. I will check that out for more ideas! We will keep trying until we find what works best for him.

@cardamom Yes Joslin is an incredible resource for us and my son did see an exercise physiologist at Joslin, but it really wasn’t very helpful. She basically discussed things that we already knew and were doing.

1 Like
29

That’s too bad—you’d think they would be more useful around these issues especially with all the college students around. :frowning:

1 Like
30

I rowed crew in college, but it was so long ago my experience is pretty irrelevant. Crew is a year-round sport, exercising every day. Diabetes back then was once a day NPH injection, no BG meters, no A1c tests. Self management via urine test strips. I never talked to my coaches about having T1 diabetes and I don’t believe they knew. I always carried sugar (lifesavers mostly) and ate them when I felt low - that was pretty much the level of BG management back then.

That said, I’m very glad I rowed crew, since it got me active and unlike everyone my age that I work with I have continued to exercise, rowing or running, and I believe that has been important in keeping me healthy with many years of T1.

4 Likes
31

Depending on the level of school, the athletic department may be able to offer resources. Absent that, I can discuss in great detail what we do for baseball if you think that would be of any value. However, my son has no compunction at all with checking his bg. He uses a Dexcom and also does a blood stick every time he gets to the dugout. Since he catches, we only get the dexcom updates when he is in the dugout since he isn’t able to manage a phone during the game.

My son uses a pump, but we use an untethered approach, where 50% of his basal is provided from Lantus, and then the pump makes up the other half. During baseball warmups he removes his pump, and that usually is idea so his bg drifts upward slightly during a game. Then each inning he decides whether to add insulin or food to the equation. We also, have only had a few lows during games, but one of them was when a pitcher was hurling a 70+ mph fastball at him, and he was so out of it he let it hit is helmet, then couldn’t track it even though it was right under his feet.

1 Like
32

@Chris How old is your son? I can’t imagine my son checking his bg every time he goes to the dugout. That is great discipline! My son is a pitcher and also catches some and plays some 3rd and shortstop. We have found that the catching drops his blood sugar faster than the pitching. He has really only had one game where he had to sit out due to a low. His coach had him catch both games of a doubleheader. He ended up having to forfeit his at bat until we could get his bg back up.
I would love to hear what his routine is and how it works for him. Does he experience post game lows several hours later?

1 Like
33

@mlg, does your son lower his basal before a game?

34

@Michel Yes he does lower his basal rate. It can be difficult though because you never know what to expect in terms of how much activity there will be. He usually knows in advance if he is the starting pitcher, but when he is not, he gets to the field and they tell him which position he will play. He does not have to prepare much if he is just playing infield, but if he is catching, he needs to lower basal and have carbs. I would like him to be able to lower his basal rate an hour or more before the game to try to keep him more level, but that is often not possible.

1 Like
35

My son is currently 15, but obviously his last season was when he was 14. Yes, he is very disciplined, I wish I could take credit for this, but honestly, this is all him. He admits that he skips it sometimes, but the longest he will go without a blood stick is every other inning.

In our experience, lows a few hours after a game, indicates too much insulin on board during the game. Even if it is just too much basal.

My son catches at least 4 inning a game, so we don’t really know what it is like when he isn’t catching. Everything we do is tuned for playing half the game at catcher. Our goal with his basal insulin, is to have him at a slight rise for a “routine” game, and to have to eat carbs in an intense or long game. In those cases when he has an easy game, he generally doses in the 4th inning.

It sounds like your son’s trending down during some games, which we work hard to ensure doesn’t happen on a regular basis. You may need to develop a few different routines, including pre-game food intake to adjust for the variable conditions your son plays. Also, the coach may be able to give him some insight into what each day holds so you can fine tune. Our head coach won’t do this, but some of the assistants will.

2 Likes
36

Do they do the standard one hour warm-up? We are always able to reduce our basal during these times, because that is how long the warm-up usually is.

37

Another thought. In our area there is a T1 that is playing Division 1 Football, and he has been a great mentor to our son. Really, really amazing young man. You should check at the program’s you are applying to with the coaches, I can almost guarantee that there will be at least one T1 among them. Perhaps it would be helpful if your son had a mentor that is going through the same things. I have yet to meet a T1 athlete that wouldn’t help another T1.

6 Likes
38

@Chris, this is really wonderful. I wish there was such a “program” across schools around the country. It would make such a difference, first when you get diagnosed, but also when you start getting active in sports and fall into all the traps we have all found before figuring them out.

2 Likes
39

@Chris You are lucky your son is so disciplined. Good for him.
I am hoping this will come with maturity in my son. I have seen it a bit and really stress to him that he needs to make sure diabetes doesn’t become an issue on the field. At this level, coaches have so many players to pick from, we don’t want this to become the deciding factor.

They do an hour of warm up before the game, but then they are running sprints and already throwing.

That is great that he has a mentor who is an athlete. How did you find him? At this point, we are not discussing the fact that he has diabetes with the program’s he is applying to. We want him to be able to compete on his own merit and not let the diabetes piece influence the coaches.

2 Likes
40

Ours was offered up by our local community. When my son was diagnosed we reached out to everyone we knew to let them know about our new situation. We did this so we would not have to keep telling the diagnosis story ,and to make sure everyone was aware among his friends and their parents. The result of this was so amazing I can’t even begin to tell you.

We quickly had coffee invitations at multiple houses where families answered every question we had, showed us all manner of technology we were ignorant about, loaned us additional meters to try, gave us things they weren’t going to use but that might help us, and introduced my son to all of the other T1’s in our area, which included one fine young man who graduated last year after playing 4 years of D1 football.

Everyone has their own way when engaged in college recruiting and sports, but I would think it worth consideration that the fact that your son has T1 shows that he is more disciplined (even if not perfectly) than many of the other players, and that he has overcome more than just learning to play baseball. If the program is interested in the toughness of their team, I would think this would be a benefit. my 2 cents.

5 Likes