I am a newly diagnosed Type 1 Diabetic, diagnosed on Friday 8/14/15. My plan is to get off shots and move to a insulin pump in the next 6-12 months. I’ve been trying to research insulin pumps and I’m having trouble finding any good information about insulin pumps for athletes. I was wondering if anyone has any good recommendations? My background is endurance based, marathon, 70.3, 140.6, etc. any help would be great. Thanks all.
Set it to 100psi. 90 if you’re riding chipseal.
Edit:
I would actually be interested to read about blood sugar management for endurance athletes with diabetes.
If you do a search, there’s a pretty long thread (probably hasn’t been posted to in a few months) about diabetes and racing. It turns out there’s a handful of us (type 1’s) on this forum.
I’m certain that being on a pump would help my control, but I’m still holding out. I’ve managed pretty well on MDI for the last 3 years and I like the freedom that it gives me. I’m sure you’ll get some mixed reviews on which pump to use, but I can tell you that I’d look at Omnipod. It’s currently the only tubeless pump on the market.
Also, if you haven’t already, I would 100% get a Dexcom. I feel naked without it when I’m working out.
Good luck on your journey through diabetes.
My daughter is T1 and we have had her on an Animas Ping (or whatever it’s precursor was) for 6 years. It’s been near flawless and customer support is pretty good. It’s waterproof and if it can survive a licking from a 10 year old girl you would probably have a tough time wrecking it.
We also find the software and data for BG tracking useful.
there is a ton of information out there re: insulin dependent and exercise.
I am assuming since the diagnosis… you have been reading a bunch!!
In regards to the question regarding which pump…
My recommendation would be to contact each company and have the sales rep come visit you and then get all the information that works best for you and your lifestyle.
My daughter has type 1 and liking see all the reps at our house rather than at the doctor’s office. Just felt more relaxed to make a decision at home. She chose the Tandem t: slim.
Also reach out to the team at Team Novo Nordisk. (http://www.teamnovonordisk.com) I am sure they have a ton of information re: long distance as all the cyclist are type 1.
best of luck!!
The pump would prob be easier for longer events- the last 70.3 I did
It got very hot and I found I needed a lot of insulin. I injected 7 units on the bike course straight into my leg while coasting. It was too late too because dehydration caught up to me from being too lean on insulin. I would seriously consider it for long course. Omnipod, animas vibe/ping or something waterproof.
I’m on mdi and do sprint distance only so haven’t gone the pump route yet.
Type 1 diabetic for about 20 years, insulin pump for about 10. I use the Medtronic Minimed Paradigm and I find that it works fine when I exercise. For anything that under an hour I just take it off completely. The exercise will lower my blood sugar enough that the lack of basal won’t result in hyperglycemia. For longer bouts, if its non-contact (I sometimes play pick up basketball where I have to take it off no matter what) I have no problem leaving it on and just having the pump in my pocket. It works fine and I can dial in more or less as I need it. In general I find setting a temporarily reduced basal is good for long runs or bikes. For swims you obviously have to take it off, but I can’t imagine too many swims that are so long that it is a big deal. For instance if you take 90 minutes to finish an ironman swim, I think it is fine to put it on during T1. 90 minutes without basal while you are exercising shouldn’t be an issue, especially if you give a small bolus before, after, or both.
I would strongly suggest switching over to the insulin pump from shots, though. Insulin pump offers a lot more flexibility in terms of insulin regimen when it comes to exercise than shots can offer.
very true - the negative of shots is that you have to feed the basal during training (and usually give yourself more bolus/rapid insulin for a race!)
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Just out of curiosity, do you use ultralente for your basal?
never heard of it? im in australia we might not have it? im on lantus…our options are pretty much that and levimer…im only on 7 units a day, purely because of training sensitivity. Stop training and that would easily triple.
Ah yeah, Lantus. I used that for several years when I was on the XC team in high school before I switched to a pump. My issue with that was always it was too much insulin WHILE I was running and not enough at other times. So I would either get low during XC or high other times. Ended up just having to eat a bunch of food before/while I ran which was annoying. I love the adjustibility of a pump.
I’ve had T1D for 23 years and have done tons of endurance sports with and without the pump. Now that I’m on the pump (Animas Vibe with integrated Dexcom CGM), I can’t imagine going back. The ability to fine-tune basal rates throughout the day and during different training intensity levels just isn’t possible with MDI. The continuous glucose monitor is also an incredibly valuable tool.
As a side note, check out the Riding on Insulin Ironman team - a group of 36 Type 1s (myself included) are doing IMWI together next month. The team also has a Facebook group that would be a great resource if you want to bounce some questions off some experienced veterans. Good luck with your decision!
My wife has been T1D for just over 20 years, diagnosed at 17. She’s been using the pump (Medtronic MiniMed) for about 12 years.
She has been extremely athletic her entire life. Played collegiate soccer, and is still playing in competitive rec leagues. We both (although not as much the past 2-3 years) do a lot of endurance MTB racing, up to and including quite a few 24hr races. No stage races… yet 
She always had a difficult time managing her levels when taking shots, and not just when she was being active. Factors such as temperature, stress, emotions, her cycle, and other intangibles seemed to drastically change how her body reacted and absorbed the insulin via shots from one day or even hour to the next.
Moving to the MiniMed literally changed her life. She is able to eat what she wants, when she wants. She is able to be much more spontaneous. She is able to control (this is big for her) the delivery of insulin so much better. Prior to the pump she would have several low level events a week (she rarely goes very high, even now). I shudder at those memories… Since the pump her levels have significantly normalized. Extreme low levels that would happen multiple times a week are now so rare I can count yearly instances on one hand. TBH, for her, the biggest hurdle has been (and I suspect always will be as long as she’s on a pump) the mental aspect, specifically the frustration/realization that she has to be connected to a medical device 24/7.
As the pump relates to her activity;
Short term activities; Soccer games, run or mtb ride under 2 hours, lounging or swimming at the pool, etc: Typically she will adjust prior to the activity then remove her pump during. As time allows she will check levels or adjust (half time, etc) but she has become quite in tune with how her body reacts and can go a few hours without checking or adjusting.
Longer/Endurance activities; For long road rides she will typically just wear her pump. For long MTB training/casual rides she often wears her pump, but will occasionally ride unplugged, but carry the pump with her in a camalbak. For MTB races of any length she will remove the pump. Races under 30 miles it’s 50/50 on whether she brings the pump with her. Usually depends on how she feels that morning. If we are doing a tag-team endurance race, she will connect and adjust while I am riding. If we are racing solo endurance events, we will set up a pit tent. She will take quick breaks every 1-3 laps depending on lap length and how she is feeling to check and adjust if needed. She does not carry the pump with her to avoid potential damage should she crash.
From a SO of a T1D’s point of view, I can tell you that my peace of mind is infinitely stronger with her on the pump. She is a teacher and takes full advantage of her summers off, riding 2-4 hours nearly every day (yes, I’m jealous…) While I worry about her safety, it’s mostly due to traffic concerns, and not her diabetes. Were she still taking shots, based on the way she reacted to them, I would feel much differently.
Lastly, her Endo recently got her samples of the new inhalable insulin. (Sorry, I don’t recall manufacturer) So far she prefers using her pump for activity, and typically only uses the inhalable first thing in the morning, or in the event of high levels that she wants to bring down quickly. She loves how it works, but has a hard time actually inhaling as it often gives her coughing fits.
All that said, as you’ll learn or already know, the control of diabetes and how your body reacts to insulin, regardless of the delivery method, is highly dependent on millions of factors, so, YMMV…
One last thing!
If you haven’t, yet, get yourself a RoadID clearly stating that you’re T1D
My wife was the victim of a hit-n-run a few years ago. No major injuries (slight concussion, road rash), but, by the time paramedics arrived she had gone quit low due to shock/adrenaline/etc. Had she not been wearing the RoadID, they may have mistaken her “loopy” state of mind as simply due to shock, and not caught that her sugar levels were getting dangerously low.
Female 35 year T1d here. I was until recently on the Medtronic 530g with the CGM. Last year was when I decided it was time to try the pump as I signed up for 2 70.3’s. The 1st event I had the CGM and it was a disaster. Alarms going off and ended up being more of a pain so I disconnected the CGM and have not used it since.
For the swim I disconnected and tested myself in T1 and reconnected at a 20% basal for the remainder of the event. I find that for anything under an hour I do well being disconnected. I really like the pump for ease of insulin delivery. However the tube was a pain to deal with so I decided to take a break from the pump a month ago (went back to the pens) and have not had any issues with long workouts of going high/low.
I looked into the Omnipod and like the idea of being tubeless, however, its bulky and felt there was really no discrete place to put it without it being so noticeable. I heard great things about the Dexcom and you can use this with or without a pump.
Like others said, I would look at the each one suggested and see what fits your lifestyle. Many of the manufacturers offer a free no risk 30 day trial.
I was diagnosed in 1985. The first ~15 years I was on the injection regimen…1 shot/day, the 2/day, then the pen. I was put on the pump around the year 2000. I had the choice of Disetronic or Minimed. I went with the Disetronic ( https://www.accu-chekinsulinpumps.com/ipus/products/insulinpumps/htronplus.html ) At the time (15 years ago:) they would give you two pumps. They didn’t want you to go without one while the other one was in for service, updates, etc. Plus at the time, the Desetronic was water proof, the Minimed wasn’t.
Sometimes I would wear in during the swim portion & sometimes I wouldn’t. I would then just hook it up in T1 and off I go. The pump was the second best decision I made regarding my diabetes.
I still have my two Disetronics. I no longer need them. I had a pancreas transplant 10+ years ago.
Take care.
Here are some threads re IM & diabetes.
http://forum.slowtwitch.com/gforum.cgi?do=post_view_flat;post=4839016;page=1;sb=post_latest_reply;so=ASC;mh=25;
I am a newly diagnosed Type 1 Diabetic, diagnosed on Friday 8/14/15. My plan is to get off shots and move to a insulin pump in the next 6-12 months. I’ve been trying to research insulin pumps and I’m having trouble finding any good information about insulin pumps for athletes. I was wondering if anyone has any good recommendations? My background is endurance based, marathon, 70.3, 140.6, etc. any help would be great. Thanks all.
Welcome to the group! Oh it’s so much fun…
For pumps, I really like my Tandem t:slim. It’s touch screen. Def. one to check out. But as someone else said, you should contact all the reps (MM, Animas, Tandem) and try them out. You will also want a CGM. Dexcom is the way to go there.
There’s a few books out there like “Pumping Insulin” that might be a good place to start. You have a LOT to learn, but don’t get frustrated. There’s going to be a lot of trail and error. It’s just the way it’s going to be for you now.
I’m doing IMWI in a few weeks with a group called Riding on Insulin. We have 30+ athletes with T1 heading to WI with a ton of T3s (loved ones that support us). Should be fun (hopefully).
… you would probably have a tough time wrecking it.
I pretty much landed on my Animas Pump when I crashed at IMAZ. Other than a few scratches, it was fine.
As others have suggested, far and away the biggest benefit of a pump when it comes to being athletic is fine-grained control over your basals. The ability to ramp up your basal rate when sick or stressed, and reduce or even eliminate it for periods of exercise as needed, is life-changing. It also enables some pretty amazing bolus options, including microdoses, superbolusing to give yourself a blast of insulin up front (for example to quickly correct a high or match a higher-carb meal) and then subtract the extra you’ve given up front from your basal rate for a period of time, post hoc dosing changes if, for example, you dose more bolus than you needed, you can just subtract it from your basal as a proxy for going back in time and taking less bolus, etc. All of these things would work even better with more fast-acting insulin, but even current fast-acting analogs enable some pretty amazing stuff.
P.S. The Omnipod is an intriguing option but gets very mixed reviews, seems to be a love/hate thing. Being tethered isn’t nearly as big a deal as it seems upfront for many folks, and comes with some important advantages. Lots of good options out there!