Some sports stuff for @ABCD

Sorry for the belated gratitude, but the start of the school year and soccer season have been quite hectic for us…Thank you for the help with the Bluejay watch setup. My son has been using it during soccer games…he wears his Dexcom on the back of his arm, and we found that wearing the watch on his wrist often resulted in a lack of connection…often not updating for 15 or more minutes. Luckily my son is quite thin and he is actually able to wear the watch on his upper arm (above the elbow and below the Dex)…he covers it with a wrist band and it’s hidden by his shirt sleeve so early has he been questioned by a ref. We have a medical note from his doc in his soccer bag so hopefully it will never be an issue anyway.

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@ABCD,
The watch does take longer to connect than the other devices. So you gotta make sure you give it plenty of time to connect before the game.

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Hi @Eric . I’m going back to this post from a while ago because the after activity lows are becoming an issue as my son begins his first soccer season with a pump. As I mentioned before, his BG spikes during games (and even practices) usually up above 200 even when he gets on the field around 80 or 90…We have been leaving the Omnipod5 in Auto mode, as it gives him various amounts of micro boluses throughout the game. Unfortunately he still runs higher from the moment he starts warming up until the minute the game ends (today went from the 80’s to 220 in a matter of an hour despite the micro boluses from the automode). As soon as the game ends, his BG starts to drop…we expect this and have granola bars or carnation breakfast drinks ready for him to have soon afterwards to slow the drop, but we’re having a really hard time figuring out how to calculate carb: insulin ratio after that when he’s eating (still in Auto mode so we often only input a percentage of the actual carbs he’s eating, although I’m not sure that’s the way to go since the algorithm calculates based on trend and insulin on board which he often has because of all the micro boluses during the game). We’ve been experiencing a rollercoaster of lows to highs to lows following his games. I felt we had a much better handle on this prior to switching to a pump. Any advice?

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What settings do you have on the pump before and during the game? Do you use their “exercise” mode? Unfortunately all that does is target a higher BG number. And if it is cutting his basal before the game because it is in exercise mode, that could be part of the reason for the spike.

The other part of the reason could just be from adrenaline. That will definitely cause a spike too.

So the first thing I would want to know is if you are using the pump’s exercise algorithm, or doing any basal cuts before the game.

The pump has been giving him a lot of insulin during the game. And all the activity increases the insulin absorption. After the game, the adrenaline is gone. So that explains the drop.

Do you have basal numbers for him we can talk about adjusting? I am not a big fan of the pump algorithms that are just responding to BG trends and not taking all the other factors into consideration.

I think you could do a better job just turning off auto-mode and doing a manual basal adjustment after the game. Like for example, set it to 50% of his normal basal for 2 hours after the game.

For IC changes, you can do a similar thing. But if you are adjusting his basal, you would probably not need to make as much of a drastic change to his IC.

I would really consider going to manual mode for the before, during, and after game situations.

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We have not used the “Activity Mode” of the Omnipod5, although I’m thinking maybe we should switch it to that immediately AFTER the game ends to help battle the lows that follow. It would set his “target BG” to 150 rather than the usual 110… We have not adjusted any basal rates pre or post game because we have left the system in automated mode, so the basal adjusts based on his current number and trend, so during the game it is pumping it out because he spikes, and then as soon as he stops and his number starts to decrease, the automated system suspends insulin.

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I also don’t use Activity mode. Not sure what it would accomplish because normal Auto mode usually drops my basal to zero during activity.

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One suggestion for you about things like this…

I mentioned adjusting his basal post-game. Like trying 50% for a few hours after the game to see how that works.

You are thinking that “Activity Mode” might be useful, because it would also adjust his basal.

And you might think those 2 things are basically the same.

But the difference is, any pump algorithm like that always relies on the CGM. There is a lag between his BG dropping and the CGM picking that up. The lag might be even worse if he is dehydrated after a game.

If you are seeing consistent drops after the game, you can do the basal adjustment yourself and get ahead of it.

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