Hi, my eleven year old daughter is a competitive soccer player and we battle lows for the night after days with multiple soccer games, waht tips or strategies have you found to be successful in avoiding dangerous lows after strenuous exercise?
Is she on a pump? If so, reduce basal rate during exercise and in the hours after exercise (for some folks up to 12 hours). How much to reduce basal is trial and error for most people and depends on if your daughter eats during exercise. I do take some carbs during exercise (I like Hammer Gel because its more complex carb so smoother in hitting your blood stream). When I do more intense mountain biking I reduce basal to 50% starting 30 min before start. Then keep switch to around 75% for an hour or two afterwards and then make sure to be eating regularly in the 12 hours following. I’m 50 so I expect my metabolism is quite different from your daughter. Other folks will probably have some helpful guidelines on reduction rates and period of time after exercise. Bottom line is that the exercise makes your body more sensitive to insulin during and in the hours following exercise.
If she is not on a pump, but assuming she takes a basal like Lantus, you could look at reducing the dose taken the night before games…but of course that would be figured out with your doc. When I used to adventure race, I’d reduce my Lantus by 50% the night before.
I second just about word for word what @timg suggested. Yes, each of us is different in our insulin sensitivity and the duration that active insulin stays in our bodies. As I’ve aged, I’ve become more sensitive to insulin but also find that it apparently lingers longer in my body.
As an example for managing, and slightly different from Tim’s suggestion, when I’m headed out for 25 miles on my heavy mountain bike, I lower my pump basal to about 25% at least an hour before I begin peddling and always have a complex carb such as English muffin with PB just before my ride. While riding, I hydrate using a reduced strength Gatorade [I use the powder] and check my BG frequently and if necessary eat a small granola bar that has total 17 grams of carb with only 7 of those carbs being sugar. I very rarely have a “sugar spike” with this routine.
Something I have learned after much trial and error is that I need to send a signal to my body, yes trick my body into believing everything is normal activity for me. By the time I finish my ride, I usually stop a couple of miles out, I check BG and eat a snack WITH insulin - usually 2/3 the insulin I have for that snack. Somehow this signals my liver to start releasing glucagon; I don’t know how this works, but for me it mostly has solved the very low BG I’d experience, like those of your daughter, in the evening.
My son is 14yo travel soccer player and distance runner. If not on the pump, we control by reducing the bolus the meal prior to the game or long practice. The pump does allow you (as mentioned above) to do temp basal rates which we are just learning about now since he just started a pump 3 weeks ago. We also have him test as half during games and will usually consume a 16oz. G2 (not the regular gatorade). If not having luck can also recover post game with chocolate milk. We are noticing that with the hormonal changes, what worked last year doesn’t work as well now as having to adjust to those changes in addition to sports.
Good luck and let me know if you have any more specific questions.
My 7 year old also plays competitive soccer and she removes her pump while playing. We try to get her blood sugar to about 180-200 at game time and that seems to help eliminate lows for her.
I struggle as well. I am training for a triathlon, and often get low alerts on my Dexcom multiple times throughout a long run and ride, and immediately after a swim. I try gels and chews for carbs before and during, but it feels like I need to eat WAY more than I’d like just to keep from going hypo. In addition, I often have multiple night-time lows after days of extra training. I’m left feeling tired (very disruptive sleep) and sick of glucose solutions (e.g., glucose gels, fruit snacks, etc.). I’m not on the pump. I’ve dialed back my Lantus with some positive results, but still struggling to run more than a couple miles without crashing.