Nate has pump tslim x2 and cgm dexcom 5 (since last October). He has iPhone 7 he uses as transmitter. We recently got him an Applewatch for easier visibility of cgm numbers during school. Personally, inactivity during school hours is way more frustrating for Nate and I than any sporting event.
We did do this at one time with a pen and no cgm (first 2 months after diagnosis, no cgm). It is more difficult with pen and only pricks because pens can’t microdose to really small amounts, you can’t adjust basal insulin on the fly (give more, give less, turn off completely or adjust to a percentage)and you cannot see bg trending up and down, so you are always pricking. It’s more difficult to truly learn how situations impact them without a cgm.
The cgm is a must to make sure I can be as proactive as possible no matter where the numbers go. It’s definitely a balancing act that I bear the most of the responsibility of. I want him to feel as normal as possible so I do whatever I can to get him “ready” (numbers in range) before an event. This is often really difficult for me because I work with a substantial commute to home and have a small window of time to get Nate to practice (ideally 1 - 1.5 hours for food and insulin to balance out). I usually only have 45 min. As time goes by I have him share in the troubleshooting with me so that one day he can do this all on his own… maybe 11 or 12? Way too early now at 9 for him.
I always make sure he eats before he gets on the ice. More often than not his numbers go high due to adrenaline when he starts playing, especially hockey. If it’s a game he rarely gets close to low, keeping him in low enough to be in range is a challenge. If it’s a lower key practice as long as we start around 120 - 150, he is fine. But I always make sure he eats, ideally 45 min. - 1 hour before.
Baseball is lower key, but I often don’t know how his bg will be affected until we know what position he is playing 15 min. before game. Pitching and catching exerts much more energy than 1st base so again, we start in range ideally above 120 and I watch cgm. We always disconnect pump for practices and games for every sport, so again, he’s not getting basal insulin for 1- 2 hours and his bg will begin slight trending up not down.
We really don’t interrupt in the middle of what is going on unless his cgm shows a downward trend at 90. We do test before when he eats… it’s more than a snack, I generally shoot for a meal or mini meal no less than 20 carbs. We do this anyway for dinner so this really is not more pricks in most situations. Based on where his number is at before eating, we decide together if he should dose for full carbs or sometimes we do less knowing he’s got rigorous activity ahead. If his numbers shoot up our Endo has advised to leave the adrenaline rush alone. It goes down within 1 hour after event. If not we would then consider dosing lightly to bring it down. If you dose and the adrenaline comes down at same time you are more likely to hit a low.
If things look ok on Dexcom (these general trends I noted) I don’t fingerprick. I feel the less finger pricks the more unusual the event will feel for him. If numbers are trending low I do fingerprick.
Theres no exact sure way to do this, each kid, food, activity will affect them differently. I read a ton about exercise, nutrition and type 1 and learn with every event. I have some “go to” foods that are consistent with a good experience for him that generally help, but it takes some time to see patterns, I’m about 1 year into doing this with cgm and pump. I take a lot of notes on my phone so I always have them with me. Best books I’ve read are “Think Like A Pancreas” and “Sugar surfing”.
I think a cgm is most important. Do you have one? We have custom decals made for Nate’s with his team logo in them. (Cgm transmitter and pump decal). His teammates think it’s the coolest thing.
My daughter is in gymnastics and has seen some girls with cgms on their arms. I’m guessing that’s a little closer for your daughter to relate to. They have long practiced and 4 - 5 hour competitions! Cgm would be a necessity. A gym environment would e great for cgm. It’s the outdoor sports with way more distance that dont always get a read.
Sorry so much info, but I could ramble on for hours. Maybe she just needs to eat 1 hour before and do a good check 15 min before eating. Dose a little less (85% of what you would normally do) and see how it goes? Leave it up to her when she pricks again?
Admittedly, I was put in a lot of situations I didnt feel 100% great about when we started this. I had to trust in some of his decisions and respect what he wanted to do “in the moment”.
I hope this helps. With cgm and time it does get more consistent.