General Discussion Tri'ing for Weightloss » Any type 1 diabetics wearing insulin pumps? Rss Feed  
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2013-02-15 2:06 AM

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Subject: Any type 1 diabetics wearing insulin pumps?
I'm a type 1 diabetic with an insulin pump. The pump is awesome. Unfortunately it has caused me to balloon out like snoopy on Macy's Thanksgiving Day Parade. I have been biking for a while so decided to add running and swimming to the work out. I have run a 5k already and have another one Saturday. The problem is I can't seem to lose any weight. So, my question is. What diets are the pancreas challenged people using? Every time I try low carbs and high protein. My sugar drops to low. I have tried turning my pump down but that leads to higher blood sugars later. I'm very frustrated right now. I bike and run ever day haven't started the swim yet. Still haven't lost a pound and it's been 5 months.


2013-02-15 12:05 PM
in reply to: #4623228

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Subject: RE: Any type 1 diabetics wearing insulin pumps?

Hey there, you are not alone.  I have type 1 diabetes (20 yrs) and manage using a pump (10 yrs).  Yes, it is difficult to find that elusive balance, and even when we do it's a dynamic thing.  Not to mention having to eat when we get low and yes, those *&^% calories still count!

I had also let my weight creep up over time, and then lost over 25 lbs a few yrs ago.  I did it with a combination of tri training, eating less, and eating better quality foods.  I'm not a fan of eliminating or severly restricting any particular food group, though cutting back on "junk" carbs was definitely part of it.  I tracked my calories using Sparkpeople.com for a while to get a better handle on "calorie reality" and go back and do that from time to time when either the scale or my clothes are telling me I need to tone it down.  That time is upon me again, as I'm 8 lbs above where I know I run/feel best right now.

YMMV, but I tend to do best when my basal and bolus totals are roughly 50/50.  I've been marathon training lately, and before most runs I turn my pump down to 60% about an hour before I head out.  If having breakfast before, I bolus for 50% of the carbs.  Most days that works, and some days not so much.

It is definitely challenging, but worth it.  If it were not for running and triathlon training, I don't know that I would stay in the fight as much.  I enjoy those things so much that they seem to pull me along into taking care as best I can of the diabetes and weight.

2013-02-15 2:02 PM
in reply to: #4623228

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Subject: RE: Any type 1 diabetics wearing insulin pumps?
Thanks for the reply. YES! The going low and having to treat it is so frustrating. I'm on a good roll, then I have to consume un wanted calories. I still feel better and I'm actually in the best shape of my life except for the weight. So just for that reason I'm going to keep plugging along.. My Dr. Is ecstatic. He wants me to lose weight, but just doing everything needed for a Triathlon has definitely been good to me. I will try and cut down a little more on calories and also cut down my bolus even though I don't really have to much of a problem unless I don't eat carbs. Good luck to you and thanks again.
2013-02-17 8:30 PM
in reply to: #4623228

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Subject: RE: Any type 1 diabetics wearing insulin pumps?

Wanted to chime in even though I'm not on a pump (I'm on MDI).  I'm type 1 and my 12 year old son is also type 1 for 11 1/2 years.  He's been on a pump for over 8 years now.

 

For me, I try really hard to treat lows ONLY with glucose tabs.  They have only 15 calories each and if I need to treat a bad low and eat 4 tabs (16g carbs), then it's only 60 calories.  Many times I have just gone and eaten anything in sight until I feel better which is 15-20 minutes of eating and can be a TON of calories.  The glucose tabs work the fastest and have the least calories.

 

Good luck, it can be maddening....

2013-02-17 9:42 PM
in reply to: #4623228

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Subject: RE: Any type 1 diabetics wearing insulin pumps?
Yep I agree, I also try and stick to the glucose tabs.. Less calories fast acting. Sometime though like you said uncontrollable eating for 15-20 min. Those are the ones that are getting me. Ahh I digress.. I'm getting in a lot better shape even if I'm not losing weight. Can I ask a personal question. Why you stay on MDI rather than going on the pump yourself too. I don't think I ever want to go back to MDI..
2013-02-19 7:44 PM
in reply to: #4626209

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Subject: RE: Any type 1 diabetics wearing insulin pumps?

tbristol - 2013-02-17 9:42 PM Yep I agree, I also try and stick to the glucose tabs.. Less calories fast acting. Sometime though like you said uncontrollable eating for 15-20 min. Those are the ones that are getting me. Ahh I digress.. I'm getting in a lot better shape even if I'm not losing weight. Can I ask a personal question. Why you stay on MDI rather than going on the pump yourself too. I don't think I ever want to go back to MDI..

 

Happy to answer a personal question  I was diagnosed with type 1 through a research study when I was 30 years old (I'll be 37 this year).  They caught it VERY early.  Adults in my case who are diagnosed so early often have a long honeymoon (averaging 6 years), as I have.  For years I was just taking lantus, not any novolog.  However, in the last 2 years especially, the honeymoon is coming to an end.  I am definitely thinking about pumping once I am consistently taking insulin for every bite I eat.  Almost there....

 

My son is getting a new pump this year and is likely going to get the T-slim.  Going to see how he likes it.  As a female athlete, I'm a bit hesitant on how I would wear it working out, or in a dress, or having a site show through a swimsuit.  I know I need to get over it!  I'm sure I"ll be pumping in the next few years.

 

I should never have written anything about overeating.  Had a bad night last night and ate for a good 15 minutes at midnight to correct a low.  And WAY overcorrected...... Ugh!



2013-02-25 3:01 PM
in reply to: #4623228

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Caledonia
Subject: RE: Any type 1 diabetics wearing insulin pumps?

I'm also a Type I with the Minimed Paradigm.  I had a late onset of juvenile diabetes after a very traumatic experience.  (I'd be curious to hear from anyone else who had something like that.)

 

For me the pump makes working out possible.  I simply take it off when I get to the gym and put it back on when I leave.  No worries, no muss, no fuss.

I've lost 17 pounds in the last few months.  My biggest change was just cutting out fried foods.  My breakfast has shrunk considerably and my lunch consists of a salad that I make every day at work.  Dinner is just a regular dinner, with more greens and far fewer carbs.  I get most of my protein from my dinner, along with milk and yogurt (either Dannon fruit on the bottom or one of the newer greek yogurts.I can't do low carb, high protien either, it's just a hypo factory for me.

My biggest issue with what I make when I'm at home is that I have three kids aged 2, 6 and 8.  So I have to make dinners that are palatable to them as well as my wife and I. 

I started working out regularly last October.  I was up to 260+ pounds and I was loosing all of my energy, so I decided to get up early a couple times a week and run.  From the time that I was 17 until I was 22, I served in the Army as a Paratrooper and I continued to serve in the national Guard until I was 26.  Four months after I got out for good I became a Type I diabetic and I've dealt with it ever since.  I was in phenomenal shape while in the service and I stayed extremely active after I got out, I tried to keep from letting diabetes control my life but Type I changes everything.

When I got the pump it was a godsend and I had far fewer hypoglycemic incidents but it did cause me to gain weight around my waist, right where my infusion sights go in.  I was still very active for many years after I got diabetes but once the kids came around I started getting heavier and heavier.  Much of my former muscle mass deteriorated and I lost a lot of the stamina that I had.  Getting some of the muscle and stamina back is not proving as hard as loosing the weight around my spare tire.  I blame that on the insulin being pumped into it.

When doing longer workouts or activities (longer than one hour of sustained cardio) I usually put the pump back on with my basal rate set to 1/3 of my usual basal and I'll slowly sip something like a Gatorade G2.  This is particularly important on my bike, I'll go insanely low in twenty minutes if I don't do this.  But for running and swimming I usually just make sure my blood sugars are in the 140-150 range turn of the pump and go for it.

I might have gone a bit too long but this stuff lives in my head 24 hours a day and it's a bit cathartic to get it out somewhere that I can share it with others that  understand the issues and have a personal stake in it.

JT

2013-02-26 6:58 AM
in reply to: #4623228

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Subject: RE: Any type 1 diabetics wearing insulin pumps?
Hello, yes I developed type 1 after an autoimmune disease attacked my thyroid and Pancreas. They caught the thyroid problem but didn't discover the diabetes until I was in my 30's. Then it was misdiagnosed for 10yrs. They figured since I was old I must have type 2 they didn't bother doing the antibody test. So they gave me pills and told me to watch what I ate. Well ten years of not being able to control it they sent me to a specialist. 5 minutes in his office and said the problem was that I was type 1 not 2. So had to learn all new way to treat it. After a couple of years of MDI, I got a pump. So, your not alone being older and getting type 1. I agree it is so much easier to work out with the pump. Like I mentioned in my first post I can't do the low carb I get to low. No matter how much I turn my basal down. Also like you, all my weight is in my belly. I call it my insulin belly.. If I could lose that I would feel so much better. Have you done a tri yet? I'm trying to decide what to do with my pump during the swim. Not sure I want to leave it unattended in the transition area. What do you do?
2013-02-26 9:48 AM
in reply to: #4623228

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Subject: RE: Any type 1 diabetics wearing insulin pumps?

Hey there, great to read everyone's story.  It is always comforting to hear of others diagnosed "later" in life because I had such a feeling of isolation when it happened to me.  I was diagnosed with Type 1 at age 27.  Actually, like so many of you, my GP didn't know what to make of the late onset, and the fact that I was not overweight.  He kept telling me "I've never seen a case present like yours", and he tried treating me like a T2 at first.  When that didn't do the trick, I referred myself to an endoc, who confirmed that it was T1 and on insulin I went.

I generally turn my pump down to 50-65% prior to exercise.  But I also test somewhat regularly, and my body's response to exercise is not always predictable based on other variables (intensity, hormones, etc.).  Doing longer events has taught me that I need insulin and fuel, and so I sometimes find it necessary to bolus during the event, or cancel that temp basal rate.  I bolused conservatively (about 2/3 the normal correction bolus) during the marathon I did on Sunday as my BG climbed into the low 200's early in the race, then was able to take in some nutrition without getting out of the 100's again.  Race was not a good one for me, but it was at least not due to blood sugar issues this time!

As for what to do with pump during the swim of a tri, I generally either leave it on the "swim out" table if there is one, or with my husband to hand to me as I head into the first transition after the swim.  Since they ususally close transition 30 mins or so prior to the event, it can be and hour or more before getting in the water.  I don't like going without any basal insulin for an unknown amount of time like that.  I have had some horrific high BG's during tri's due to that and I assume pre-race/swim nerves.  I usually check with the race director prior to the event to see how they want it handled since having someone hand it off to you can be considered outside assistance.

 

2013-02-26 2:39 PM
in reply to: #4623228

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Caledonia
Subject: RE: Any type 1 diabetics wearing insulin pumps?

I have not done a Tri with the pump yet but I plan on putting it in the little under-seat bag on the bike or in my shoe wrapped in plastic.    My only worry is that it might get a little hot, so some ice might go in another plastic bag.  I'm not at all worried about it getting stolen, it's pretty esoteric and I doubt that anyone will notice it. 

IfI can't get to it then my wife or kids can always lob it to me on my way through the transition. 

As far as the insulin belly, has anyone else ever injected into their leg with the pump?  I've tried in but the sites don't last as long, usually only two days before they are getting too loose to work.

JT

 

2013-02-26 9:58 PM
in reply to: #4623228

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Subject: RE: Any type 1 diabetics wearing insulin pumps?

I was also diagnosed at age 27, like Squirt.  It'll be 20 years ago this August.  I was on MDI just a couple of years, and have been on Minimed (okay, Medtronic) pumps since then.  Will switch out to something else later this year, since I'm on a Dexcom CGM so there's no real reason to remain with Medtronic.

I generally leave my pump in transition for shorter tris if I'm in an early wave.  Otherwise I try to take advantage of the swim-out table, but at least once they told me (the day before when I picked up my race packet) that there would be a swim-out table, but there wasn't one.    Used a person to hold it in that case (it was local tri and one of the coaches from my training group held it).

For Ironman-length swims (which I do when? only in an Ironman), I use an Aquapac and swim with my pump.  That's too long for me to be unhooked.  If I'm unhooked from the pump, then when I hook up in T1 I take a 60-minute bolus of 150% of the basal insulin I missed when unhooked.  For the IM swims I remained hooked up and kept my basal rate at 100%.  Generally I need a _higher_ basal in the bike portion of my tris, and a _lower_ basal for the run portion.  But just when I'd think I'd established a pattern I'd have a race where all bets were off and I went terribly wacky -- I had an Olympic this past season (my 4th in tris) where I was approaching 500 in T2 and going low toward the end of my run (oh joy). 



2013-02-27 1:28 AM
in reply to: #4623228

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Subject: RE: Any type 1 diabetics wearing insulin pumps?
Well I'm really enjoying this conversation. So now I have a couple of other questions.. You guys mentioned your BG readings during the event. Is everyone using a CGM? My insurance won't cover those and I can't afford to get one on my own. So would I try to do a finger stick while running or biking? Or just in the transitions? The other question is since I haven't done a tri yet. What is a swim out table and where will it be?
2013-02-27 8:07 AM
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Subject: RE: Any type 1 diabetics wearing insulin pumps?

PrudenceR, how are you liking the Dexcom?  Do you know where they are on integrating the display into a pump screen?  I'm on a MM pump w/ CGM, but don't use the CGM all the time.  Helps me get a handle on overnight numbers more than during events/workouts.  Sometimes it works well, but others, just when I get a good trendline going, it either flatlines on me, or it's time to start a new sensor...sigh. 

tbristol, the "swim out" table is usually located on the way from where you exit the swim to T1.  Typically pretty close to the water.  However, as PrudenceR mentioned, I've had race directors promise that they would have a swim out table, and then they never set one up on race day.  Also, if you leave it on the swim out table, it can be surprisingly easy to forget to grab it (if you want to know how I know this, the details are here: http://www.beginnertriathlete.com/discussion/forums/thread-view.asp?tid=270503).  Even though I sometimes wear a CGM, I don't completely trust it and do fingersticks as well.  What length of events are you targeting?  I think that will determine when/how often you test.  I have stuck to sprints and OLY's.  I usually test in T1, not on the bike (not coordinated enough), possibly again in T2, and then have my testing kit in my amphipod belt for the run so I can test during the run if needed.  But honestly, by the time I test on the run, it's really too late to do much about it.

impulse, I haven't used a leg site in a while, but good reminder that I need to try it again.  I find it more likely that I will pull sites out when pulling pants up over it, but seems like I had pretty decent sites there.  YMMV, but for tri's I put my pump in a softsided bright green lunchbox thingie.  Has my name and race number taped onto it.  If it's really hot, I'll throw one of those re-freezable ice packs in there.   

2013-02-27 8:44 AM
in reply to: #4623228

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Caledonia
Subject: RE: Any type 1 diabetics wearing insulin pumps?

I tried the CGM but it did not work with me.  I was ripping the damned thing out of my body day and night, and when it was in it would not track my sugars correctly.  I just test regularly.

I will test in each transition and I will test while on the bike or run course if necessary.  No stopping needed. (I might make a little velcro mount on the bike, that could come in handy for training and racing.)

I am going to try a leg stick tomorrow when I change my site.  I'll report back on the results.

JT

2013-02-27 10:52 AM
in reply to: #4638672

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Subject: RE: Any type 1 diabetics wearing insulin pumps?

 

squirt - 2013-02-27 7:07 AM

PrudenceR, how are you liking the Dexcom?  Do you know where they are on integrating the display into a pump screen?  I'm on a MM pump w/ CGM, but don't use the CGM all the time.  Helps me get a handle on overnight numbers more than during events/workouts.  Sometimes it works well, but others, just when I get a good trendline going, it either flatlines on me, or it's time to start a new sensor...sigh.

I tried the Medtronic cgm on and off for a year and it worked _abysmally_ for me.  Really, far worse than no data at all -- one day it'd be 200pts off in one direction, the next, 200 off in the other direction.  Repeatedly.  Didn't tell me my patterns correctly, either.  BUT I know plenty of people who get good data from that cgm. 

The Dexcom works far better for me.  In fact, I've got the new G4 now, and that seems to work even better than the 7+ -- woohoo!  If I'm not mistaken, the delays while exercising seem shorter, too!  But they do NOT talk about this in the literature, and I've never read anyone else having this benefit, so I may be imagining things.

How often to I test in a tri?  More often than you'd think.  Always in T1, even on a Sprint.  Always in T2, except _maybe_ on a Sprint.  I test while on the bike (I mean, usually I stop, but in the bike portion) unless it's an Olympic or shorter AND things have been going well AND I trust what the cgm is telling me.  I have a meter velcro'd to my bike handlebars under the aero bar elbow rest, and the poker and strips are in my Bento box.  I take a belt on the run (except on a Sprint, but I just stopped carrying it on the 5k of a Sprint this past season) with a meter in it.

With the cgm, I calibrate in T1.  I have it attached to my bike right in front of me, and I push the button every half hour to see the number and trend/arrows.  I have it alarm me above 200 always, and I change the 'low' alarm to 80 for a race -- and a couple of days before it.  I wear it on the run and again am consulting it often.  In general, I run high on the bike and low on the run, but this is very much a YourDiabetesMayVary thing and you have to figure out what works for you.

 

2013-02-28 10:05 PM
in reply to: #4623228

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Subject: RE: Any type 1 diabetics wearing insulin pumps?
So I have had a pretty good week counting calories getting my work outs in and keeping my BG's in good range. I work 3rd shift. So I get home this morning, for some reason I'm starving. Usually I just go to bed when I get home. So I make several bad choices knowing its going to destroy the whole weeks work and raise my BG. Then go to bed. Sure enough I wake up 3 hours later and BG 235 urrgh.. So I do a correction and go back to bed. I wake up don't check my BG and hop on the bike trainer. 30 minutes in I feel my sugar going low. So I hop off check it real quick and its 39..urghhh training session done for the day. All in one day, I know its mostly my fault. Still tho very frustrating..


2013-03-02 11:14 AM
in reply to: #4623228

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Subject: RE: Any type 1 diabetics wearing insulin pumps?

Prudence, well, I guess I'm glad I'm not the only one to have diffuculty with the (not) accuracy of the MM CGM.  I shelved it completely for about a year, and have been using it intermittently over the last few months.  One good thing it does is make me pay attention and actually test more.  But that can also wear me out mentally, especially when it is going off several times during the night and interrupting my sleep.  OK if it is "right" but ticks me off when it is giving me bad data AND bad sleep!  I hope when my warranty is up to shift over to the Dex, and hopefully it will be integrated with a pump screen by then.

Tbristol, believe me, I feel your frustration.  I make my worst food choices at night when I'm tired.  I've been in a bit of a post marathon funk and am having some residual issues that are keeping me from getting back to running much.  Endorphins gone, not burning any calories, and well.....fritos, bean dip and red wine were my after dinner snack.  Yep, that certainly showed on my meter in the morning.  Feels like all is lost sometimes in those moments, but I have to remind myself that those poor choices do not negate the good choices I have made, and that I have the opportunity for a new day each and every day.   

2013-03-05 8:32 PM
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Subject: RE: Any type 1 diabetics wearing insulin pumps?
I don't know fritos and bean dip sure sound good though squirt. :-D my question is. How many calories is everyone shooting for? I'm trying for around 1500 and well I'm not losing any weight. I think 6 months of either biking and running and 1500 calories should so for something. I'm eating good carbs too. I'm really frustrated..
2013-03-06 12:21 PM
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Subject: RE: Any type 1 diabetics wearing insulin pumps?
For me (5 ft 4, 128, 46 y/o female), in order to lose I need to eat 1400-1500 calories and S/B/R for an avg of an hour/day.  I'm not tracking calories at the moment....too busy tracking everything else for upcoming appt. with a new endoc.  Anyway, if I'm really working on it, I can drop half a pound per week.  It's a slow go for sure, but I don't like doing things in too drastic a way for fear that they will be unsustainable.  Keeping carbs hovering at around 1/3 of daily calories (or 120-150g/day) seems to help too. 
2013-03-06 2:31 PM
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Subject: RE: Any type 1 diabetics wearing insulin pumps?
Wow that is a lot of carbs. If I eat that many I will for sure not lose weight. Are those carbs from fruits and vegetables? Or some whole wheat pasta and brown rice also?
2013-03-06 6:46 PM
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Subject: RE: Any type 1 diabetics wearing insulin pumps?

To each his own, but I don't really think 120-150 g is excessive.  I'm including total grams of carbohydrates from all sources.  120 g X 4 cal/gram = 480 calories from carbs.  150 g X 4 cal/gram = 600 calories from carbs. 

I'm not actively trying to lose right now, but am tracking carbs for an upcoming endoc appt.  So yesterday I had about 150 grams of carbs, which included (bkfst) 1/2c oatmeal, 1/2 apple, veggie sausage, egg / (lunch) Chicken barley veggie soup, salad with basalmic vinagrette / (snack) 1/2 a peanut butter sandwich w/ 1/2 a banana / (dinner)Beef/Bean Burrito, (snack) roasted cauliflower, raspberries. 

 



2013-03-08 12:25 PM
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Caledonia
Subject: RE: Any type 1 diabetics wearing insulin pumps?

I am happy to lose weight, but I'm not really concentrating on a specific strategy, it's been happening naturally as part of my overall fitness plan and I'm good with that.  I've changed my diet by cutting out fast food entirely and fried foods in general, with some exceptions.  My biggest change has been reducing breakfast considerably and having a salad for lunch.  Between that and working out I have lost nearly 20 pounds.  It comes off slowly but that's a good thing to me.

I really try and keep every part of my fitness regimen in some sort of flux.  I'm not hitting any plateaus but it does make it a bit harder to manage my diabetes.  I've been erring to the side of staying conscious but I'd like to get my numbers back down because I've been having some wild swings.

Counting calories is one of the least important things for me.  I'm happy with any gains I can make in any department.  If I lose weight, GREAT! but I'm just as happy to improve my endurance, reduce my waist size, reduce my basal rate or increase my upper and/or lower body strength. 

JT



Edited by Impulse 101 2013-03-08 12:26 PM
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