This is something that (I think) is very personal/individual. What works for someone else may not work for you and vice versa. Honestly, the way I figured out what worked for me was trial and error. And even so.......what I know to work for me sometimes is other times just a huge failure.
quite right Kari. was literally struggling to figure out my levels during a dance practice session. the confusion is like should i maintain my levels using temporary basal rates or should i just go with my normal rate and keep eating food; blousing just a little less than normal, because of activity.
Understand, I am not a pumper, but I have information that may be helpful. The term "Temporary Basal" is used to describe a one-time alteration of your basal profile. It can be used for a variety of different things. Some people set a temporary basal to deal with decreased (or increased) basal needs during exercise. I believe this use is described Sheri Colberg's work ("The Diabetic Athlete's Handbook"). Another use of the temporary basal is to implement the "Super Bolus."
Another good use of a temporary basal is to reduce your Insulin On Board (IOB) and avoid a low. If you have a meal, bolus and then find at 2 hours that you are at 80 mg/dl and you clearly still have IOB, rather than chowing down on a chalky glucose tab, you can set a reduced temporary basal to compensate.
Just some ideas, I am sure others have their own handly uses.
My son is supposed to put on a 50% reduction for the hour before..during and after gym class... but he forgets alot and just ends up carbing a low after. So not sure it works yet. Jury is still out. But the reasoning behind the 1 hr before during and after for the decrease is so that the IOB is decreased enough to prevent the low. Play around w/ percent decreases until you find the one that works best...
I turn my pump down when I go running, up before certain kinds of horrible foods and sometimes up and down at various times. Once I realized I was @ work and it might run out just before the end of the day so I tried turning it down and stretching it. That is probably not the best use. TLAP and Pumping insulin have this chart, of which I took a photo. I think it's online but I never remember to save the link! basically, if you are going to exercise moderately for an hour, you can use .67 the basal or bolus for .67 of the carbs? .
I don't quite use the chart, usually for a 2 hour run I'll run up a bit at the start, leave it around 80-100% until it starts to drop and then turn it down to maybe 50% and continue drinking Gatorade and various other goodies as I chug along. While it's great to have stable BG, I think that it's also important to keep fueling. If I see my BG drift up during a longer run, I usually just bolus about 1/3 the amt and it seems to hit it plenty. Generally I also turn the temp basal off and bolus 100% fulll speed ahead for about the last 3 miles as that's about 20-25 minutes and my BG seems to drift up after runs although I'm not sure if that's from overcarbing or underbolusing or adrenaline or some combo thereof. It's really more a combo of feel and data from the CGM, although the CGM is prone to crapping out at about 16 miles and reading in the 40s sometimes if I don't keep pumping it up.
I have a whole lot of respect for your ability to exercise like you do and basically use all the tools available to you to get the kind of blood sugars you are looking for. I have had a terrible time figuring out temp basals and got so frustrated with hitting 200+ with even only reducing my basal 10% I gave up on it. I find under bolusing a meal by 25% usually does me pretty good. Problem with that is I have to always plan my exercise somewhere around a meal, not too close so I have the "full" feeling while exercising, but not too long afterwards so my blood sugar does not "drift" too high before I exercise. For whatever reason the amount of insulin "taken away" from a meal bolus does not equate to "use that same reduction in basal and get similar results". Maybe it is a timing issue for me. I should also note I AM NOT an avid exerciser so perhaps I just need some more experience on this front?
Quite agree with you on that 'amount of insulin taken away.......similar result'. under bolusing works better for me too.
but ive been literally breaking my head to logically go about certain things especially temp. basal rates. This is how I look at it- 2 hours after a meal with a normal bolus, if I read around 120 and if i dont want to snack up and just move around, may be driving a car ( witha power steering :P) , for the next two hours..i would give a temp basal of 50% for an hour and get a reading around 180 at the end of the 2nd hour. So I have experimented with this couple of times and it works for me although i'm not at my best, energy wise, at the end of the 4th hour since I had my meal and usually its ' time to snack up entering the 5th hour. Do let me know what u feel about this...
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