Today we had a tough situation. One and a half hour before a game, my teen son got a strong hormone peak.
The timing could not be worse, because his insulin needs about 40 minutes to be in full force. This means that he would spend most of his game during the period of highest activation for his insulin, with an increased risk of running low.
In the end, the decision we made was to underdose for his peak by about half, so as not to have too much risk of running low. The problem is that these peaks are quite unpredictable, and may keep on rising while he plays, bringing him to an unsafely high level for sports (ketones).
He is out there right now. I can’t say I am thrilled. This is one of the few cases where we are ready, reluctantly, to use substandard solutions for his diabetes treatment. But the alternative would be to forsake an activity that a glucose-normal kid would do. There is no good choice