My T1D son (12 years old) does a lot of exercise, 10-20 hours per week depending upon the week, some of it intensive swimming practices. We are still new at this, but we have experimented quite a lot with exercise in the past 6 months. We have also researched this in the literatue, and read the Sherry Colberg book.
What we have found - for us, may or may not work with you:
- As long as you test regularly, there is no need for special trainer or educator. For us, regularly means every 30-40 minutes for a average workout, every 20 minutes for an intensive workout
- There is a "best" range of glucose for performance. My son performs best in the 120-160 range. He does not perform well when he is at 100.
- underdosing the last meal does NOT help for exercise. The "surface" glucose number (like a surface charge for a battery) drops precipitously when you start working out (confirmed by literature)
- you don't want a lot of Insulin On Board. Best have at least 2 hours since your last meal, if possible 3.
- The way we do it: 30 minutes before practice we bring his glucose to 150-175. Then we replenish it as needed all through. In a soccer practice, he tests every 30-40 minutes, and takes about 15 g of sugar every 30-40 minutes. In a swim practice, he needs to test every 20 minutes, and will typically need exactly 15g every 20 minutes.
- we taper off at the end of the practice so that he does not end up high (but be aware that at least he continues to go lower after the end of exercise).
- right after the practice, he takes 12 oz of whole milk (recommended by study), sometimes eats too depending on intensity of workout, etc. He typically doses as well.
- Before a match or a meet: we eat a high carb, medium protein, low fat meal 3.5 hours before the match/meet, then hydrate very high about 2 hours before.
My son typically keeps on going lower after exercise, fairly typical. When he is in high exercise mode, his insulin needs (TDD) are about half of what they are if is not exercising at all: we were able to figure this out during the Xmas vacations:-) So beware the fact that your basal needs and/or bolus needs may change.
Feel free to message me if you want to chat directly on the phone.