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My 16 year old son (diagnosed 4 yrs ago) went off the pump a couple of months ago. Instead, he takes Lantus, which is split into am and pm doses...he has dawn phenomenon so he gets more in the morning. Total Daily Dose is about 70 units. He plays football and wrestles and had figured out how to prepare for them, using a combination of temp basals and extra carbs while on the pump. Football season is starting, and we have no idea how to adjust his Lantus.

Any input is greatly appreciated. Thanks!

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I shot myself 16 units of Lantus in the morning and 8 at nights. I train 5 days at weeks and is almost impossible to me adjust the night dose in order to avoid the hypos in the middle of the night. The only way that I found to solve this problem is to increase my BG before going to bed, with a glass of orange juice, no matter if my BG is 170 or 220. When I exercise my BG drop at midnight 100 - 200 points. At night my body is like a machine sucking of glucose hehe.
When I do not train, my glucose only drops 30 - 50 points.
My son definitely drops at night so he always pushes it up at bedtime after a day with excercise....a glucose sucking machine...yep, that sounds like him, too!
That does sound scary. Being able to turn off the basal is a big advantage to the pump. A friend shared with me that she had a similar incident with her daughter...they kept giving her carbs and testing...went on for hours.
I'm on Lantus and never adjust it for exercise. I only adjust my fast acting insulin. I either take less insulin or eat more before exercise (Depending on the type of exercise...aerobic lowers my sugar and anaerobic raises it.) I only adjust my lantus depending on how high or low my sugars over a week or so period.

You son might be getting hypo hours exercise, because after exercise your body is very sensitive to insulin (and other hormones and nutrients) because your cells are craving to be restore. If he doesn't already, he should try taking less insulin after exercise.
Some people (and children in particular) experience post exercise hypos. These cannot be explained simply from increased insulin sensitivity. Some people believe that it is related to your body trying to restore glycogen stores. I have these sorts of hypos about two hours after exercise, but have been able to reduce/eliminate them by eating a good meal (with bolus) within 2 hours. But these hypos can occur up to 48 hours after exercise and they can occur at night. Our fellow member Cheryl posted an interesting presentation on this topic some time ago.
Thanks for the link. There is a lot of information and I am going to have my son look through the powerpoint, too.
He did make adjustments on day two on his food boluses and was happy with the results while he was at football practice. The first day he had to sit out for 25 minutes, the second day he didn't have to sit out at all. He still continued to drop the rest of the day and into the night. He was giving himself about a 50% bolus on his food.

The good news is that the coaches tell me the level of activity at the practices is going to be very consistent, so once he gets it all figured out, he should be set.

I ball girl at tennis tournaments - not so fun when Tsonga is serving at your leg - and for the week I put my Lantus down one or two at most and usually only inject my Novorapid for main meals and not snacks. This however is for a week of non-stop concentration and movement in the full sun (don't know if this affects anyone else but put me in the sun and my insulin seems to work ten times more efficiently!). Hope this is some help!

Used to use Lantus and it's a nightmare when it comes to exercise. Basically it has a very long tail to it's activity, it's meant to last for 24hrs, but the main curve which kicks in after about 4hrs tends to last for about 18hrs ish depending on dose size, and the tail can linger on for up to 2 days. Due to fluctuations it caused on one a day I ended up on the twice a day Lantus, but the tails just ended up over lapping and it got even messier to keep control of. Before a sportiv I would need to stop my Lantus two days before hand, and just go off correcting with the basal till after the ride as riding with the Lantus in my system was causing a massive increase in the need for constant carbs (which yes is still necessary while riding but not quiet as much).

When finally getting a pump and not needing Lantus and having the flexibility to knock my bolus down easily and quickly it pretty much doubled my range capable due to not needing to carry as much fuel.

I ran track throughout high school (just graduated) on both Lantus/Humalog and the omnipod. Let me tell you, the omnipod made it so much easier. I know he had a lot of problems with the Animas Ping (read a comment), but I have to support the omnipod here. I've never had a problem with it like you described.

Back in freshman and sophomore year, before I started pumping, I ate peanut butter sandwiches to boost my blood sugar before practices and sipping gatorade throughout practice to keep it in the right place. Honestly, it's a guessing game. The DNE gave me suggestions of carb loads to eat and various ideas, but none of them worked quite right, I worked out my own routine.

Sorry that this is pretty useless information. I just want to reinforce that it's trial and error, and that he's going to have to test very frequently for the first week or so. He may want to consider a CGM, although it's going to be very hard to keep it from being damaged during drills. It'll be useful during conditioning.




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