By: Sheri Colberg
While exercise can improve your body’s sensitivity to insulin, it can also complicate blood glucose (BG) control. Normally, exercise causes your body to use more blood sugar without insulin. Therefore, when insulin users participate in physical activities, they frequently need to make insulin adjustments to keep BGs normal.
Studies have shown that with pump therapy, BG levels fall less during moderate exercise compared with conventional insulin delivery. Insulin-pump therapy allows these exercisers to achieve the most normal metabolic response to exercise. An undeniable advantage of wearing an insulin pump is the precision and speed with which an exerciser can make insulin adjustments.
How to Achieve Optimal Control
To achieve optimal control, you may need to make appropriate insulin reductions for planned exercise, closely following an insulin bolus to minimize your insulin levels and risk for low blood sugars during and following exercise.
Several brands of open-looped pump systems are currently available on the market. All of them deliver insulin into a skin site (abdomen, buttocks, legs or upper arms), usually through a Teflon infusion catheter. The infusion set is replaced every two to three days at an alternate site.
Choosing the Right Pump for Your Exercise Regimen
Choosing which insulin pump to use is a matter of preference, and you can use all of the current models effectively for most types of physical activity.
Current insulin pumps provide a variety of features such as different basal increments and duration, basal profiles, frequency of basal insulin delivery, temporary basal rate settings, bolus increments, bolus delivery, size, cost, use in water and other unique features.
With regard to exercise, the most important features of the pump are basal rate and bolus increments, basal profiles and temporary basal settings. Certain pump models have the ability to adjust for extended periods of exercise, either planned or spontaneous, through refinements in basal rate reduction.
Drawbacks of Pumping and Exercising
A few potential drawbacks of insulin-pump use with exercise need to be noted. For one, excessive sweating has the potential to dislodge your subcutaneous infusion set. To prevent this, you can use liquid skin preparations like Skin-Tac and stronger adhesives to anchor the set more firmly to your skin.
You can also apply antiperspirant at your infusion site to minimize sweating beneath it.
Especially with vigorous exercise, replace your insulin-infusion set every two to three days as recommended. Also, check the integrity of your infusion site following vigorous exercise, sweating or water contact. Insulin is temperature-sensitive and exercise in hot or cold environments can potentially cause insulin to degrade and lose its effectiveness.
What if I Get Unexpected Highs After I Exercise?
If you experience unexpected high blood sugars after exercise, replace both your infusion set and insulin in the reservoir as a precaution. Diabetic ketoacidosis (DKA), a life-threatening condition that may require emergency treatment, can begin as few as five hours following the displacement of your infusion set. (Note: Always remember, if your blood sugar is over 250 mg/dl twice in a row, take an injection of insulin to prevent DKA.)
Overall, wearing an insulin pump and staying physically active is a great combination for managing your diabetes..