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untethering for exercise

Discussion in 'Parents of Children with Type 1' started by rutgers1, Jun 4, 2012.

  1. rutgers1

    rutgers1 Approved members

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    Matt is SO sensitive to exercise that we have to take off the pump or do a 0% temp basal any time he is doing anything that involves extended amounts of running/exercise.

    For those of you who disconnect your child's pump during exercise, how long can it be disconnected?

    Matt was disconnected for a couple hours the other day and pretty much stayed at the same blood sugar level the whole time. It was great. However, I am wondering if there is a reason that I am unaware of for him NEEDING to receive some basal at different points during that time-span. In other words, I am wondering if there is a limit to the time period a child can be disconnected.

    Thanks!
     
  2. hawkeyegirl

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    We cannot disconnect for more than 90 minutes or we are looking at highs with ketones later, regardless of how strenuous the exercise is.
     
  3. Sarah Maddie's Mom

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    For us, any disconnect causes highs, even with sports. Though we do disconnect for swimming. Then, I think it's as much the cold water as the exercise that keeps her from going high. Even a long shower or bath, disconnected, can cause a spike.
     
  4. rutgers1

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    So you are saying that you need some insulin to keep your child from going high during exercise, or that the high comes on later?

    With Matt, even if we disconnect for two hours during strenuous exercise, we have to then run a temp basal at 80% for the next few hours (sometime through the night) to stop him from going low. His body is a carb/sugar burning engine that can't be stopped once it gets going.
     
  5. mysweetwill

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    We can disconnect for several hours and not worry about highs, I think we have gone 3 hours so far. In those instances, Will has been very active and we have connected because he was hungry and needed to bolus, not because of highs. Im not sure how much longer than that Im willing to try but its a good question. I know there will be beach days that we will likely go untethered all day, in those cases I will likely give him a shot of lantus in the am.
     
  6. Sarah Maddie's Mom

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    She'll go high without insulin even when she's exercising. Even when it's like our Weds evenings when she has lax from 5:30 -8:15, she leaves her pump on, then when she has a late snack we underbolus a bit to stave off any 1:00AM lows

    Maybe for the first 5 or so years we had more latitude to disconnect, now, not so much.
     
  7. emm142

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    In the beginning I could disconnect for 3ish hours with minimal issues. Now a 1 hour disconnect is problematic if I don't have Lantus on board. That's part of why I'm now incorporating a shot of Lantus into my regimen. :)
     
  8. RomeoEcho

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    I think it depends on your DIA. Exercise increases insulin sensitivity. It doesn't matter how insulin sensitive you are if you have no insulin to use. So yes, there is a limit to how long you can disconnect for even if you are really active. If he is too sensitive to have basal, he may need a snack with a bolus if he is going to be really active for a long time. Another thing to try is to reduce basal for an hour or two before the activity so that there is less insulin floating around his system when he starts getting more sensitive. It is generally better to use reduced basals before and after rather than stopping for extended periods of time.

    If he is still honeymooning and making some insulin himself, than this may not apply. You need some insulin from somewhere, so if he's making some of his own this may be enough when he's really active.
     
  9. Lee

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    We used to give a 15 gr snack, bolus like normal so we would have some insulin in the body and then disconnect. Worked like a charm and then puberty hit.

    Now we do completely untethered - 100% for the sports - and she has no problems at all during exercise, even with a full Lantus dose on board. She just needs the insulin, even with exercise.
     
  10. emm142

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    I take 10U Lantus per day, supplemented with 7U basal delivered by pump. With that 10U, I still need to carb up a little before exercise - around 10g carbs per 15 minutes of running.

    But before I added Lantus, disconnecting the pump for 1 hour or more was a recipe for disaster. It works better this way. :)
     
  11. Beach bum

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    Same here.

    If we disconnect for 90, then we have to do an increased basal overnight, usually 30% for at least 3 hours.

    In the summer due to so much activity where the pump is removed, we've gone the route of using Levimere in the day and then hooking the pump back up for a small amount of additional basal overnight.
     
  12. LJM

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    After 4 years this is what we see now too, almost exactly. First 2.5 years we could disconnect without problems. Now if he disconnects even an hour to do a workout---we will see a high later. So we usually stay connected for everything/ or give missing basal with disconnecting.
     
  13. Tigerlilly's mom

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    Same here...this is really what pushed us to the untethered approach.
     
  14. Sarah Maddie's Mom

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    We may give this a whirl this summer.

    And to the OP, just to be clear, the term "untethered" is more that just disconnecting for a period of time. It's pretty specific and refers to using an injection of long acting basal insulin and just reconnecting the pump to bolus.
     
  15. quiltinmom

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    There are two things that you need to watch when disconnecting; highs and ketones. If neither are a problem then you're probably okay for whatever amt of time (within reason) that works for you. It seems that you are Lready doing everything right.

    Good luck!
     
  16. Lee

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    We are on month 9 of untethered. Coco loves it, I hate it. We first tried doing 80% Lantus, 20% basal, but we got so toppsy turvy that we just switched to 100% Lantus basal. It is going pretty good. But I do miss the ability to use temp basals.

    On the other hand, Coco loves not having to sleep with her pump, play with her pump, live every second with her pump, so we keep trying to make it work. But yeah, I kinda secretly hate it.
     
  17. Butterfly Betty

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    Sophie can disconnect for up to two hours before we notice any change in her bg. Even after we reconnect, we have to do a temp basal at -20% for two hours to keep from sending her low.
     
  18. Lee

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    Coco used to be able to do that; now, if she goes 1 hour, she is 400, if not high.
     
  19. mmgirls

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    I am not sure that we are all talking about the same thing, the term "unteethered' generally means that the erson is taking Latus or Levimir or some other type of "basal" insulin other than fast acting from the pump.

    Disconnecting is just diconnecting, NOT going unteethered.

    we have now done both, ut will wait to comment once I have clarification on the question.
     

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