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Practice makes near perfect at bedtime

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The Question
Wed Oct 10 11:38:05 UTC 2012

My 10 yo daughter does competitive swimming and has 1.5 hour swim practices 4x per week. We cannot get decent control. Can any suggest a regimen?
Asked By: parentsofk  
Category: Exercise

Background Info Hide
She's on a pump. We give her 40-50 carbs 1 hour before practice (approx 5pm), and only bolus 25% of it. We do this because she generally drops a lot during practice. Even with this, we often find her dropping 2 or 3 points per minute and being in danger of going low and have to give tabs or juice. She starts practice in 200s, ends low 100s. After swimming she has dinner (approx 9pm) and then she goes really high. Like high 200s to mid 300s for hours. She then goes low in the early morning (5am-7am) Should we be giving less carbs upfront and more during the practice? Does she go high after practice because her pre-swim carbs finally start digesting? Appreciate any pointers.
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Expert Answers (1)
2012-10-11 07:28:28.0

Dear ParentsofK,

Controlling blood glucose levels around workouts is definitely challenging, but it can be done. One thing I would suggest is trying to figure out how to make your daughter's circulating insulin levels as low as possible during practice because her blood glucose drops a lot then. You may want to consider cutting back on the pre-workout carbs some, and definitely don't give her any rapid-acting insulin within 2-3 hours of her practices. The reason is that without diabetes and injected insulin, the body normally decreases insulin levels dramatically during exercise. Both insulin and contractions independently cause blood glucose to be used, and you only want to have the contractions doing it, not both, to avoid lows.

She can also supplement with a small carb snack before she starts and maybe something easy to absorb, like a sports drink, every 15 minutes or so during practices. You can only absorb so many carbs while exercising, and eating too many before or during can definitely cause blood glucose levels to rise afterwards.

Finally, for her dinner meal, it should be fine for her to eat a normal meal, but she likely will need less insulin to cover it then normal. Go for a balance of carbs, protein, and fat to keep her from going too low overnight.

Good luck with it! You will get it figured out.
Accreditations: PhD, FACSM
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Community Answers (1)
2013-07-04 17:54:09.0

My husband and I are both diabetic and experience something similar when we exercise. I do hot yoga in the morning before work, and go low during the session, but skyrocket for a couple of hours after. I was told that some of it is because of the adrenaline from the exercise as well, because my blood sugars are high even if I don't eat after the workout. I'm honestly still trying to figure it out but it seems like certain foods don't work for me personally after a workout (like milk, it runs me high in the morning especially). Being a little higher before the workout, a lower basal during, and some protein right after have been the best combination so far. I also use a square wave for a couple of hours after the workout and take a couple of units during that time to offset the spikes I know I will get. Perhaps you can experiment with that with your daughter? Also, you're an awesome mother for encouraging your daughter to continue to pursue competitive swimming despite the difficulties it brings you in trying to control her health.
Answered By: saira

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