Therapies and Physical Activity

See the sections below for guidance on how to manage your injections or pump during sports and other physical activities.

Low Intensity Sports

(When heart rate is not elevated for extended periods. Includes activities like walking, baseball, and swimming for pleasure.)
Insulin
Use typical insulin dose
Glucose Testing
Test prior to and after exercise
Carbohydrate Coverage If glucose is less than 100 prior to exercise, use 15 grams quick-acting carbohydrate. If glucose is over 100, no additional carbohydrates are necessary.

Moderate and High Intensity Sports

(When heart rate is elevated for > 30 minutses. Activities include aerobics, cycling, football, soccer, lacrosse, ice hockey, and competitive swimming.)
Insulin
Decrease amount of fast-acting insulin prior to beginning activity, by 1-2 units. If activity is in the evening, decrease the amount of long-acting insulin by 2 units and titrate as needed.
Glucose Testing
Test before activity. If playing for more than 30 minutes, test in the middle of the game/session and at its conclusion.
Carbohydrate Coverage If blood glucose is less than 150 at start of activity, use 10-15 grams of quick-acting carbohydrate. If glucose is 100-150 at start of activity, sip on Gatorade during breaks.

Low Intensity Sports

(When heart rate is not elevated for extended periods. Includes activities like walking, baseball, and swimming for pleasure.)
Insulin
Except for swimming, leave the pump on for less active sports. If pump is disconnected, glucose will increase in 60-90 minutes. Bolus for one hour of basal rate when disconnecting and do not disconnect for more than 2 hours!
Glucose Testing
Test when disconnecting and reconnecting.
Carbohydrate Coverage Give 10-15 grams of carbohydrate if blood sugar is less than 100 prior to exercise. No carbohydrate is needed if glucose is greater than 100.

Moderate and High Intensity Sports

(When heart rate is elevated for > 30 minutes. Activities include aerobics, cycling, football, soccer, lacrosse, ice hockey, and competitive swimming.)
Insulin

Disconnecting pump 60 minutes prior to exercise will help prevent low blood sugar and extra carbohydrate coverage may not be needed. If pump is disconnected at beginning of activity, follow carbohydrate guideline.

NEVER SUSPEND pump for more than 2 hours. Temporary basal rate may be needed for nighttime; start with 50-70% and go up or down as needed.
Glucose Testing
Test before activity. If playing for more than 30 minutes, test in the middle of the game/session and at its end.
Carbohydrate Coverage If blood glucose is less than 100 at start of activity, use 10-15 grams of quick-acting carbohydrate. If glucose is 100-150 at start of activity, alternate sips of Gatorade and water during breaks. If above 150, additional carbohydrates probably won't be needed.