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Exercising With an Insulin Pump

by Sheri Colberg, PhD

  • The degree to which basal and bolus doses can be fine-tuned. Some pumps allow the user to fine-tune doses to the nearest one-tenth of a unit, whereas others allow the user to fine-tune doses to the nearest one-fortieth of a unit. Being able to make very small changes in insulin delivery may be particularly important to insulin-sensitive individuals, such as those on a total daily insulin dose of 30 units or less.
  • How a pump handles temporary basal settings. Pumps vary in the degree to which a temporary basal setting can be fine-tuned and the length of time a temporary setting can be maintained.
  • The ability to deliver extended boluses. If insulin must be bolused shortly before exercise, giving a bolus over a period of time can help lower the risk of hypoglycemia during the activity by keeping circulating insulin levels lower.
  • For swimmers, whether a pump is waterproof.
  • Pump precautions
    Some possible drawbacks of insulin pump use with exercise are important to know about. Excessive sweating can cause your subcutaneous infusion set to dislodge, which may result in elevated blood glucose or ketoacidosis if you fail to notice the displacement for some time. To prevent infusion set displacement due to sweating, try using a liquid skin preparation such as Skin-Tac-H to anchor the set more firmly to your skin, or apply additional tape below the infusion set. You can also apply antiperspirant to your skin around the infusion site to minimize sweating beneath it. Or you can try wearing the infusion set in an area of the body that experiences less movement with activity, such as the buttocks. A potential problem for those using metal needles is irritation of the infusion site as a result of movement or contact. Flexible plastic infusion sets do not cause this problem.

    Especially when you exercise vigorously, you must adhere to the recommendation to replace your insulin infusion set every two to three days to prevent displacement or irritation at the insertion site. It is also recommended that you check the integrity of your infusion site following vigorous exercise, sweating, or water contact.

    Another potential problem is that insulin is temperature-sensitive. Exercise in hot or cold environments can potentially cause insulin to degrade and lose effectiveness. When an insulin pump is placed close to your body during exercise in the heat, the insulin may become overheated; if the pump is placed outside your clothing in the cold, the insulin may freeze. If unexpected high blood glucose arises following such conditions, replace both the infusion set and the insulin in the reservoir as a precaution.

    Especially with the use of rapid-acting insulin analogs in your pump, DKA can begin as few as five hours following the displacement of your infusion set. When you become insulin-deficient due to any interruption of insulin delivery, exercise can exacerbate this situation and cause DKA to occur even more rapidly. Due to the severity of DKA, insulin pump users must be especially vigilant about maintaining the integrity of their infusion sites during exercise to prevent it from occurring.

    In general, pump users should replace their entire cartridge and infusion set at the first sign of any unanticipated high blood glucose that does not respond to additional boluses.

    Maintaining blood glucose control
    To keep your blood glucose in the target range during and after exercise, follow some basic guidelines:

    Understand the nature of the activity. Some activities, such as weight lifting, use mainly anaerobic energy sources and can have a markedly different effect on blood glucose level than prolonged or moderate-intensity aerobic exercise such as walking. Short-term, high-intensity anaerobic exercise can stimulate hormones that counteract the effects of insulin and often cause an increase in blood glucose level that can last for an hour or more after exercise. Mild to moderate aerobic exercise, on the other hand, tends to cause a decrease in blood glucose level.

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    Also in this article:
    Sample Basal Profiles



    More articles on Tools & Technology
    More articles on Insulin & Other Injected Drugs
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    Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.



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