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Pump user. Use Lantus on vacation?

Discussion in 'Parents of Children with Type 1' started by Theo's dad Joe, Dec 20, 2016.

  1. Theo's dad Joe

    Theo's dad Joe Approved members

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    We are going on a short vacation in the mountains. Theo will do a little skiing, and sledding and also spend time in the pool pretty much one of these things after each meal for 4 days.

    We use the T-slim and I thought I might give him a shot of Lantus either the the first night or first morning and then just connect the pump for boluses and corrections.

    My reasoning is just that it will avoid having to have the pump out in the snow, falling down, or taking it to the pool as he would not have to hook up for basal.

    We have been on the pump for 5 months now and my main goal is to keep it simple for him. With the Lantus he won't have to worry about getting way behind on basal, but on the other hand, he probably could disconnect for 90 minutes given that he will be super active during those periods.

    Just wondering what people would recommend? Lantus plus pump boluses or reconnect. This is a trial run for summer where we might be at water parks for quite a while and don't want to connect back so often.

    Since we would just be connecting up for meals and corrections I was not going to make a new profile with minimal or zero basal. Can you program zero basal? Also will the insulin evaporate from the end of the set if it is disconnected for 8-9 hours (all night for example). I could keep it running, but if I suspend it, I was not told that I might need to prime a small amount before reconnecting if it has evaporated at the tip.

    Even if I try to stick with the pump and reconnections, I may try a Lantus day just to practice. I know his Lantus gets weaker at about 17-18 hours so if I give it in the morning, I will probably need a correction about 3 am in which case I might as well leave the pump connected at night and suspended, or I can give it at night.
     
  2. obtainedmist

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    I know others have more experience with this than I, but it sounds MORE complicated going the Lantus and reconnecting for bolus than just keeping it connected or disconnect when vigorously exercising! Being in the snow with a pump is totally fine as long as it is close to the body. The t:slim is very durable and falling down with it shouldn't be a problem. I know some on this forum play football with it on! :eek: Also, you might want to know how his body reacts to skiing and sledding. If he drops quickly with these activities, I would want to be more in control of the basal using a pump (I think you can shut down for a number of hours and still stay connected) than with the Lantus which can't be shut off! My daughter always disconnects when she is on the treadmill or in a Yoga class. She'll give herself a bit of insulin before, depending on the activity. Also keep in mind that some activities with stop and go action sometimes make bgs rise! Hope someone else can give a first hand experience here! Have a wonderful holiday! Sounds like tons of fun!
     
  3. MomofSweetOne

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    I agree with ^^ that it sounds more complicated than just reconnecting. Water play and snow are such basal need drop that I wouldn't want to be without the temp basal option, but I will add the disclaimer that Lantus hurt my daughter and she never wants to use it again. We got the Omnipod through Cut-the-Cord, and if they still have such an option, I would highly, highly recommend it. We've been able to transfer between pumps without setting problems. She uses the pods on her arms & tubed sites elsewhere, so she does a better rotation using both. She prefers the tubed pumps mostly because she doesn't like to look for The Brick when she wants to eat, but she definitely likes the option to switch between when she's tired of D and irritated at the pump in question. She wore the pod all summer because of the freedom it allowed her activity-wise, but as soon as summer ended, she was delighted to return to the tubed pump. Now she's wearing the pod again for a different reason.

    Having the pod also gives a back-up pump with pump failures. We don't even have a Lantus prescription.

    Be aware that Lantus can take several days to build to full dose and then take several days to completely drop basal to normal again. But some people switch regularly and like it, so it's obviously something that they're willing to work with.
     
  4. Beach bum

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    Snow sports can play some tricks on the body. You will be surprised at how little insulin is needed due to the legs working so much, the cold and overall how much energy is spent. We ski all the time and we reduce basal by 50% 2 hours prior, during and then drop to 30% for overnight. The benefit is you have more control than with Lantus. If you are finding that he's running low/high, you can do a quick basal adjustment. We put the pump in a ziplock bag inside the snow pants. As for the meter, they keep them with a hand warmer in the inside pocket of their coats. Works fine for us. We also test every 3 runs or so, though the CGM comes in really handy for that now. Protein bars are a must.
     
  5. Megnyc

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    I grew up skiing competitively with my pump and never took it off. I would typically wear it in a pouch around my waist under my coat/fleece but over my long underwear or just clip it to my pants facing in. For racing, I would wear long underwear under the racing suit and I would just clip it to the top of the pants. It's way easier now because the old CGMs would not read through layers of clothes. I wouldn't want to deal with lantus because you will probably want to reduce basal overnight.
     
  6. Snowflake

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    I think I was on a similar thread last winter, possibly with some of the same posters. :) What you need to know is that some T1s plummet skiing, others skyrocket. It's totally ydmv.

    We ski all the time, too, and we find that my daughter's bgs shoot up, often immediately to 300, and then stay up without vigorous attention and correction. It might be the stop-and-go aspect. It might be the adrenaline and excitement, since skiing is both her very favorite thing and also incredibly challenging for her little body. It might also be that we live at 5,000 feet but ski at 9,000-11,000 feet -- I've heard anecdotal evidence that high altitude can cause insulin resistance. Or it might just be the typical mountain high carb-high protein breakfast, who knows!

    So, I wouldn't go in to the trip expecting a particular bg pattern. If it were me, I would want the control of running temporary basal changes, but whatever you decide, I would think of each day as trial and error.
     
  7. Snowflake

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    This is a good point. Whatever happens to his bgs on the mountain, you should anticipate overnight lows.
     
  8. Theo's dad Joe

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    We will stick with the pump though I brought lantus. He slid low at nights on lantus last year. Thank's all. It's helpful. My biggest worry was landing on the pump and damaging it but it looks like that is unlikely.
     
  9. Theo's dad Joe

    Theo's dad Joe Approved members

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    It was a good thing to disconnect. We went to the pool for only about 90 min and he still went through 30 extra grams of carbs but no lows. I will probably set the basal low to start the night too.

    I don't want to start another thread so could someone remind me what kind of wrap is good around an arm or leg with
    Dexcom? I tried medical self adhesive wrapping but it didn't work in the pool. It's not critical now but for water slides in the summer. Thanks.
     

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