Swimming and LOW, LOW, LOW overnight

TiaG
Mon, 19 Jun 2017 14:11:16 +0000
New T1/LADA

Last night was the worst night we’ve had in a while.

We went to a kids’ swimming pool yesterday and Samson spent two hours frolicking in the water. But then last night we were just seesawing from low to not-low. We had to give him 7 separate carb treatments (honey shots while he slept) between 9pm and 4am. He spent much of the night between 40 and 50 on Dexcom (slightly higher when finger-tested…but not enough to not be low). Finally at 5am, when he STILL wasn’t rising, I woke him up so he could drink a half-glass of Fairlife chocolate milk and a scoop of peanut butter. And of course, at that point he spiked to 267 and we’re still waiting for him to come down enough before we serve breakfast.

I guess I’m wondering what we can do to stop these incredibly persistent lows overnight when he has a day of intense swimming activity? And just generally how to deal with prolonged swimming – he’s off his pump and we often have a lot of chaos and other factors to manage so it gets tricky to precisely time boluses, hooking up, unhooking etc.

For the swimming itself, we took him off his pump and he was 165, he spent two hours with no basal and was in the 150s, then started crashing and so we gave him about 15 g carbs (apple slices, cheddar crackers and bell pepper), reconnected his pump and gave him about 75% of the missed basal he received… and of course then he spiked to 250 for 3 hours despite receiving 1.2 units of insulin over the next hour. (there was also a sunblock miscommunication meaning his arms got a little burnt, which could have been a factor).

For dinner we went to a Malaysian restaurant and he only ate the carbs (left the shrimp, satay and tofu, and ate roti and rice only ).

My questions:

He ate plenty of carbs yesterday – so why did he crash so hard and so persistently overnight?

What can we do to prevent such intense lows overnight?

When he does have those types of post-exercise lows, will it help to give him some protein & fat with it to prevent boomeranging back down? And if so, what is something with protein and fat I can literally squirt in his mouth while he sleeps? I was sort of debating making some kind of peanut-butter/protein powder mini-smoothie but I doubt I could fit that into a 5mL syringe or something compact enough to feed him overnight.

How should we have bolused him after his swim so that he didn’t spike to 250+ for 3 hours?

Any suggestions would be most helpful. Samson adores being in the water and we’d love to do this more, but last night was a long, long night and we’re still dealing with the BG hangover. I don’t want to let this stop us, but it’s super frustrating as well.

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