Daisy Mae's swimming BG thread

Sports & Exercise
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1273

yes. this is something that eric figured out for me. when i turn off my pump in order to prep for my swim (b/c i want as little IOB as possible while i swim) i do a tiny, micro dose of insulin to keep my BG from spiking. i go from HAVING basal on board, to having 0% on board. when i have 0% on board, if i did not give myself that tiny bolus, i would spike. and i would spike very quickly.

i know this to be true b/c i have tried turning off my pump in the past w/out giving myself any bolus. i will go from 100 to 150 within just 1/2 an hour after i turn off my pump. if i take that little bolus, i will stay at 100 going up just minimally for the next 2.5 hours. for example, within the first hour, i will stay at 100 or even dip a little, but by the time 2 hours have past on 0% basal, my #s will climb. to prevent the high spike (maybe to 200), that little bolus keeps me basically steady at around 130 before my swim. sometimes, i need a little more, sometimes a little less, depending on my BG at the time i turn off my pump. anywhere from .3 units to .6 units keeps me from that spike. yes, i will still have a tiny bit of IOB when i jump into the pool (about .1 units), but this does not effect me much.

i hope i am being clear and helping you to understand the process. if i am not being clear, let me know and i will try to explain this process better.

thanks for asking,
DM

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1274

michel, did i explain myself so that i made sense to you? let me know. yours is a great question. i doubt i have ever explained this process before.

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1275

A LOWERED TEMP BASAL SINCE RETURNING TO THE POOL:

as i said a couple of posts ago, i was expecting on readjusting my basal and ICRs once i began swimming again. well that time has come! (and it really snuck up on me)

last night during dinner, my BG went down to 40. i was gulping OJ and eating chocolate like they were going out of style. i couldnt bring my BGs up. i tuned my pump down to 90% temp basal and just kept testing every 15 minutes. (boy it would have been great to have a CGM during times like this)

finally at 11pm, i got my BG up to 106. a safe target range for bedtime. phew. i wasnt certain whether to keep the TB on for overnight, but from past experience and a hunch, i decided to turn off the TB. i woke up at around 5 or 6 am and my BG was 144 !!! (and this is without the lowered TB)

well, i did a minor correction, brought my BG down to 100 and bolused for Bfast. then, right after taking my last spoonful, my BGs dropped to 42. i turned on the lowered TB and gulped down a glass of OJ. i waited 1/2 hour and re-tested. nothing. i had some more juice. tested and waited. finally, some movement; i came up to 59. it took from 10:45am to 1pm to get up to 66. (the rest of my day was much better once that TB kicked in. in my 80s all day and right through dinner.

dont think i will keep it on throughout the nightā€¦just a hunch.

i will be swimming tomorrow. so i would like to get this nailed down as soon and as fast as possible. dont say i didnt warn you !! :blush:. i knew this was coming, i just didnt know when, and i certainly didnt think that it would happen so soon.

this amazes me. doesnt this just blow your mind :wink: !!!

my daytime basals for the past 3 months have been .525 throughout the day. on the 90% TB my basal rate is .450 . thats quite a difference in just three days of swimming (well, i know i swam in Florida, but that wasnt really hard swimming).

and i think that soon there will be some adjustments to my ICRs as well. we will see. and whatever tomorrow brings, will be interesting as well. another learning experience.

signing off,
DM

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1276

Can you figure out what times you might need a lower-than-before basal and set just those times on a different program? Like maybe when exercising your night program could be lower?

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1277

great question. i think i will play around with that, b/c i have 2 other basal profiles on my pump. since i dont swim the same way each day that i swim, it becomes a little tricky, but not impossible. i could set one profile for concurrent swims, like 3 days in a row swims. or weekends, when i dont swim.

the only thing that is keeping me from setting that now is that i am not totally set for finding my basal rates since i started swimming again, after having not swam for 3 months. everything is in flux. my basal rates, daytime as well as night time. and, as well, my IC ratios are changing.

but, i know that what you are suggesting is a great idea :sunny: and will set that up for myself as soon as my insulin needs settle in. also, i know that i will always have the option of doing TBs when i need them.

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1278

EXPERIMENTING WITH A LONGER DISCONNECT:
i tried this once before, but i honestly dont remember the outcome, so i will repeat myself. sorry guys. as i am still trying to keep from crashing my first 1/2 hour to the first full hour, i am turning off my pump for 3 hours now before jumping into the pool. i am on total 0% basal. no IOB at all. and yet i am still dropping considerably rather than reaching the BG plateau sooner. here are my numbers and you can see how obvious this is, even when you look at my previous posts regarding my BGs.

(and BTW, i did make one mistake today; i did not follow ericā€™s instruction regarding when to take a Gtab if i am low. while i was prepping, my BG went down to 79 on 0% basal; in a nervous type of panic, i took a Gtab at home, instead of waiting till i was ready to jump into the pool. i went from 79 up to 157 within just 1 hour!!! wont be doing that again :wink: )

here are the stats for todays 2 hour swim:

1pm at home BG 79
2pm BG 157
2:30 BG 138
3pm BG 106
3:30 BG 89
4pm BG 85

so if you look at my #s it is clear that despite the long prep with no insulin, i am still dropping significantly within that first hour.

if anyone out there has any ideas, however silly you might judge them to be, i am completely open to suggestions. COMPLETELY. i will try anything :blush:

Thanks Everyone. have a great weekend. iā€™ll be back in the pool on Monday. signing off,
DM

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1279

A gtab right when you jump in the pool will reduce that early drop.

Your body will always pull glucose from your blood as you go from a restful state to activity. It is the easiest form of energy, so it will do that naturally. A little carb bump right before you start will help.

Do it right before, and donā€™t overdo it. Try 5-10 grams to begin with, and see how it works.

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1280

Yes, thanks very much!

I am intrigued because this is the one respect where my sonā€™s swimming process differs from yours. He does not bolus when shutting off his basal. This may have to do with the fact that he does that later than you, typically 45 minutes before practice.

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1281

does your son turn off his basal for as long as i do (3hours) ? also, does his bolus at 45 minutes crash him at all when he starts his swim? when he turns off his basal, does he spike at all?

very curious.

1282

Chris, i was re-reading my thread from the beginning, and i saw your post. this is so caring and encouraging. i am so pleased that there are those who do donate their time to helping others. i used to do a LOY of volunteer work and i know the feeling of that that one experiences. its priceless. keep paying it forward, Daisy Mae

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1283

That makes a lot of sense!! I didnā€™t think of it before but once you explained it, I get it. :slight_smile:

On another note, @Thomas had a post about treating lows overnight and he uses a temp basal if his daughter goes low to fend off subsequent lows in the night. Iā€™m pretty sure you said you were doing something along those lines but I thought Iā€™d mention for good measure. When Eric is low at night we sometimes forget we can do that. :slight_smile:

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1284

this is so crazy, b/c so many have suggested that i beware of my overnight BGs. if i turn down my basal rate with a TB, i go HIGH, not stable. i have tested this so many times, i am certain that i can use a TB of 90% after my swim, but i MUST turn it off before i go to sleep.

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1285

DM, he turns his basal off 45 minutes before practice. Then he turns it back on 20 minutes before the end, and boluses for up to 1/2 of basal missed plus 2/3 of carbs right after practice (typically 15-30 carbs). When he is out of the water, he boluses (he aims a little short with the bolus) forvery large carb dinner 45 minutes later.

He does not bolus when he turns his basal off.

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1286

is your son on The Pod? b/c i am on the Medtronic, and i cannot wear it in the water; i think that might be one of the reasons i have to bolus so strongly right after my swim.

so he still has a lot of IOB from his basal. he doesnt crash the way that i do while swimming? or is he constantly carbing during his swim session?

1287

Yes. Swimming is the primary reason why. But it would not be the end of the world if he only turned it on at the end though.

I forgot to mention that he tries to start around 125. He typically eats a few carbs 20 minutes before getting into the water. I think what happens is that his carbs counter the IOB left in the first 15-20 minutes, then there is no significant IOB left and he cruises through. He does not drop significantly, in general, when swimming.

Many things still happen, though. The biggest issue right now is that he may have had a hormone peak recently, in which case he is full of IOB and he drops fast during practice. Another issue is if he is right in the middle of a peak. If he is too high (225 or more for us) he misses practice. If he is lower, we are very careful, but we have to build a custom plan then.

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1288

flexibility seems to be the one constant in living w/ D. :smile:

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1289

EXPERIMENT IN FINDING PATTERNS:

you know how i have been talking about the changes i have been anticipating since i went from my surgical recovery of no swimming, right back into swimming strong for 4 days a week? well, looking over my obscene amount of detailed daily notes, i was able to find an interesting pattern.

you guys are always encouraging me to watch my BGs in the evenings and overnight, and i continue to report that i do not have to do a lowered TB at all, and that even when i have tried to lower my overnight basal, my BGs go high. well, one thing that has emerged is that instead of going low overnight on the days that i swim, i go high in the evenings on the days that i do not swim." i found this very interesting. starting at around 6pm - 8pm, i will go from a perfect in target flat line, to an gradual elevation up to 150 with no other reason than i need more basal insulin. i have found myself constantly correcting for the highs every night that i do not swim that day.

TravelingOn suggested that i make a different profile for swimming and non-swimming days in my pump. so after noticing this pattern last night, i took the advice and made an alternate pump basal profile for myself. now i can just go back and forth with ease instead of having to do these corrections. now, i havent tried this yet, but i hope that it works out for me. it would be wonderful if it did. :sunny:

now, i have been waiting 3 full hours off all basal and IOB BEFORE i start my swim. my numbers are, for whatever reason, very similar to those i had before, when i was only waiting 2.5 hours off of my basal. immediate drop in the first 1/2 to 1 full hour, and then a nice plateau.

i need to tweak this formula. thereā€™s got to be some way that i can start at a lower BG and maintain a nice flat line. i am now on another mission! :wink:

stats for today (so you can see what i am talking about) :slight_smile:
2pm BG 150 (right before i get into the pool and exactly 3 hours completely off my pump)
2:30 BG 149
3pm BG 122
3:30 BG 109
4pm BG 111 (bolused for replacement basal 2.5 units)
4:30 BG 107( bolused for recovery carbs/protein 1.6 units)

if anyone has any suggestions, i am open to trying anything (within reason) that would help me to find the sweet spot wherein i can begin my swim lower and not drop so significantly until my fourth hour off all insulin. looking forward to hearing back from you!!!

signing off,
DM

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1290

EXPERIMENTING ON A "BAD DAY #1:

spiked from Bfast, big time. went from 87 to 203. changed out my pump, but did not think to put in fresh insulin. duh. call me a dummy; thats OK. i deserve it.

prepped for my swim. my high BG was not going to deter me. i bolused extra when i turned off my pump in an effort to bring my BGs down.

this, unfortunately, did not help. eric suggested that i take a modest IM shot, but (and you already know that i am a dummy) i did not take his advice. i felt too nervous to have so much IOB going into the pool. i wish i had listened to him.

anyway, i persevered. i went to the pool, and before i jumped in, i tested and my BG was 232. OMG. F-it. i jumped in anyway, figuring that i had IOB and that the execise would bring me down. i swam for 2 hours, until my BG had come down to 112.

i am too embarrassed to show you the stats for todayā€™s swim. truly. but afterwards, i bolused strongly to replace my missed basal. when i got home 1/2 hour later, i re-tested and not only was there no downward movement, but my BGs had elevated again. UGH. so i changed my entire pump (again) and put in fresh insulin. i bolused for my protein/carbs shakes, and i waited. i waited another 1/2 hour, and finally my BGs started coming down; when they reached 112, i drank my shakes. my last finger stick showed that my BG was 85.

today really frustrated me. I really wanted to just scream. BUT, i didnt let that interfere with my plan for myself. so there, D, dont bother with DM 'cause she means business!!!

hope that this helps someone who is struggling with stubborn BGs whether they be high or low. this will happen sometimes, and we just need to remind ourselves how brave we are for remaining flexible and moving forward, despite the mountain we feel we may be climbing.

WE ARE UNLIMITED WHEN WE CHOSE TO BE!!!
signing off,
DM

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1291

Sorry about your tough day. It looked like a bad spike, which is why I wanted you to do that extra IM.

Thatā€™s the thing about formulas, they donā€™t always work because things are not always the same. You have your formula for a pre-bolus amount, but when you are spiking through the roof, you just need to throw that out and follow a different plan.

If you have more IOB when you are swimming and you are nervous about it, just be more aggressive with carbs when you start to drop.

Itā€™s okay you got in your workout. Donā€™t be down about it, itā€™s a victory that you still were able to swim.

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1292

Fascinating about finding the pattern! Iā€™ve often thought that when EH runs, and then doesnā€™t run, itā€™s really noticeable on the off days. I havenā€™t kept detailed notes recently though, but Iā€™m sure it would be fascinating!

Hope those basal profiles help make life easier!

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