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Competitive Swimming/Swimming Practice

Discussion in 'Parents of Children with Type 1' started by parentsofk, Oct 10, 2012.

  1. parentsofk

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    I've seen various people talk about this, but would love to run by you folks what we're doing for my daughter's swimming practices and how it is not working!

    She is 10, on a pump, and has 1.5 hour hard practices 3-4 times a week.

    Here's how it's been going.

    1) At 5:30pm, about 1 hour before practice, she eats a grilled cheese sandwich or bowl of pasta. It's about 40-50 carbs but we only bolus about 25%.
    This is based on oft repeated experience of her heading low during practice and needing to be given juice or tabs.

    2) At 6:30pm she takes off her pump and starts her practice. She checks herself before she goes in and then every 30 mins.
    Typically she is on the high end at the start (low 200s) and steadily comes down during practice. Sometimes, inspite of the pre-swim unbolused carbs, she needs juice or tabs to stop a steep downward trend which would end up with her going low.

    3) At 8:00pm she comes out and we check and she will typically be in range or a bit high - say 180ish or something. We typically give her 1 unit at this point - partly to make up for lost basal, partly to compensate for unbolused/undigested carbs, partly to cover carbs to be consumed in her dinner.

    4) At 8:30pm we get home, check again (she's usually climbed a good 50-100 points) and she has dinner! That's another 40-60 carbs, and we have played around bolusing different amounts of this.

    5) 9:30pm - 4:00am she goes sky-rocket high. Raging high. Like in the 300s (and sometimes worse) high. We correct 1-2 times.

    6) By 8am she is often in range or a bit low.

    Our regime is clearly not working well.
    We're wondering...
    - Too many carbs before and after swimming?
    - Foods too low on glycemic index?
    - Give less carb upfront, but have her sip something through practice?
    - Give her a bit of make-up insulin towards end of practice since she's been off the pump over 1 hour.

    I know we ultimately have to take notes and make adjustments (which we started doing), but would just be grateful of some suggestions from folks who've dealt with this sort of thing and found some things that helped (including good reading material).

    Thanks so much,

    Paul
     
  2. Our3girls

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    We had this same problem over the summer. We ended up finding that 3 oz seriously 4 was too much and 2 not enough 30 minutes before going in the pool and then sipping on a 12 oz full carb gatorade through out practice and then as soon as she got out giving 1/2 unit and 150% temp basal for 2 hours sometimes extended for 3-4 hours worked "most" of the time. If we tried just giving a bolus she would go low then high later so the temp basal was pivitol for us.
    Her numbers had to be 180-230 entering the pool or she would go low. We have a friend whos son plays competative water polo and they reduce basal the night before a tournament and don't bolus for the meal prior to entering the pool (would never work for us though as she would sky rockets). Lots of trial and error.
    Good luck.
     
  3. MomofSweetOne

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    We took Gary Scheiner's T1U Exercise class, and it has helped us a lot with swimming. He said that performance is best around 120 and recommended carbing to get to 150. We try not to have IOB, so we use foods that have carbs but are filling....like green beans. We test her every 30 minutes during swimming and give her carbs to get her back to 150.

    The pump, Gary said, needs to not be disconnected more than an hour or it will cause highs later. We either reconnect each hour or she wears an aquapack on 50% basal starting an hour before swimming to after swimming.

    Since we started following his advice, my daughter has stayed between 90 & 150 even if she swims for several hours.
     
    Last edited: Oct 10, 2012
  4. hawkeyegirl

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    Just curious, when you reconnect hourly, do you bolus for the 50% basal missed, or some other amount?
     
  5. momtojess

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    Whenever Jess has prolonged periodsof exercise without the pump, we have to run a temp basal that basically doubles her missed basal for about 3-4 hours after she is finished.
     
  6. joy orz

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    Ava is a mess if we ever disconnect for swimming. I give her an uncovered snack, but keep the basal going.

    She uses the Ping and she swam every day all summer for the last four years without a problem. We put it in a spi belt and she wears it sort of on the small of her back. Or she wears surfer shorts and it's on her hip.

    Her lessons are only 30-45 minutes, but there are drills and so a carb snack with a protein works as long as she's had it 20 minutes ahead of time. Usually this will put her in the pool in the mid 200's then it comes down as she swims.

    Maybe consider switching to the omni pod?
     
  7. Beach bum

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    Would you ever consider going untethered for swim season? A lot of people do it for sports, we do it for the summer. For us, it was easier to remove the pump and do untethered because most of our swimming/sailing is at the beach and it's just easier to take it off so that it doesn't snag on something. We gave a shot in the am, plugged in for bolus/corrections and then put the pump on at night for a basal boost.

    Just a thought...
     
  8. MomofSweetOne

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    50% of basal. Sorry about that! She's also on 50% for an hour before beginning as well.
     
  9. 3kidlets

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    Hana is a competitive swimmer which is the reason she chose the OmniPod. I know it would not be a good thing is she missed basal.
    We met with Gary Scheiner when she was first dx to get the practice numbers in shape as well competing numbers.
    Hana will not swim well if she is in the high 100s, so ideally se has to be 150 or under going in to practice - which is a challenge timing dinner with the practice. She will sip on a Gatorade throughout the practice to keep her numbers stable, which seems to work, rather than going in on the high side and swimming the number down. She gets out after the first 30 minutes to test, as that seems to be when she drops the most. If she is on the low side at that point, she will eat a couple of peanut butter crackers.
    I would think that the climb you are seeing after practice is either from the grilled cheese or the missed basal. Is there something else she could eat prior to practice? I'm thinking maybe it is a fat spike you are seeing. Hana spikes huge from cheese several hours after eating it.
     
  10. Amy C.

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    I would give a bolus for all the basal missed after she finishes swimming.
     
  11. Sarah Maddie's Mom

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    I think I'd ditch the carb pre-swim meal and have her eat an omelet with no bolus and then have a small carb smack maybe 10g, something fast and non-fatty.

    It looks to me that the food, plus the missed basal is the problem.
     
  12. parentsofk

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    Thanks everyone. Really busy with work, but read your responses through later today. Thanks so much.
     
  13. Flutterby

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    This is what I think as well. I think you're doubling up there with the food and the missed basal.
     
  14. parentsofk

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    Thanks again everyone, we have some great take-aways from this:

    Reduce carbs/fat in pre-swim meal
    E.g. 10-20 carbs, fast acting instead of ?meal?
    Will try tonight!

    Don?t be off pump for 1? hours
    ? hour from end, make up missed basal
    Will try tonight!

    Try to have no IOB
    Smaller pre-swim snack, no insulin for it.

    Take Gary Scheiner's T1U Exercise class

    Keep Pump on: use Aquapac
    http://store.aquapac.net/insulin-pump-case-158a-29.html

    Use a higher temp rate after being off pump
    3-4 hours +50 to +100%
    Will try tonight!
     
  15. MomofSweetOne

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    Just be careful not to mix and match too many of the strategies! If you bolus the basal at 50% throughout the practice, you shouldn't need to give extra basal afterwards and could end up fighting lows if you do. If you don't replace the basal, then your child will be missing basal for the next four hours (give or take) and will need extra to compensate for that.
     

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