Jason Fairbrother was diagnosed with type 1 diabetes (T1D) at 3. Now 50, he uses an YpsoPump paired with a Libre3+ continuous glucose monitor (CGM).
Jason shared his experience of using an AID system (insulin pump with a CGM) as part of our guide to exercise and T1D.
How do you find using an AID system?
It’s mostly fine, though I can’t compare much to a non-AID pump system beyond my first week on the pump before switching on CamAPS (an adaptive hybrid closed-loop app).
One of my biggest issues with MDI was early-morning lows followed by rebounds, probably due to the dawn phenomenon. AID is brilliant for periods with no food or exercise, like sleeping or having surgery, and keeps me very stable at night unless I’m unwell or have played tennis that day.
During the day, however, it hasn’t yet learned my patterns of running low at certain times, even if I adjust my target BGL, and it can be slow to correct highs. You still need to get bolus amounts right for meals and actively monitor and react to your levels.
The ease-off and boost functions are useful too, but I wish the adjustments could be more than 30%, as I usually need over 50% changes.
What main sports or exercise do you do now?
Walking, tennis, and gardening.
How does exercise affect your BGLs?
Exercise makes insulin work more effectively, so my BGLs generally drop, especially when there’s more insulin on board.
I used to think exercise involving arms, like washing the car, would make them drop more. That might still be the case, but I’m not sure.
When I play tennis, my BGLs tend to run lower for the next 24 hours, whereas less intensive exercise only affects levels for a few hours.
What do you to get ready before exercising?
If I know exactly when I’m going to exercise, I try to remember to use the ‘ease off’ function on my pump about an hour or so before.
If I have a main meal soon-ish before a high intensity workout like tennis, I’ll cut my bolus to about half the usual. I prefer to be around 10.0mmol/L before I play tennis, as it gives me a decent buffer if I start to drop quickly.
How do you manage your T1D while working out?
If I’m walking or gardening, I’ll use the “ease-off” function on my pump and eat more food if needed.
When I’m playing tennis, I’ll completely disconnect my pump. I usually stay disconnected for around 2 hours. I very rarely need insulin during a game, and that’s only if I’ve miscalculated something or if I’m unwell.
I also have a smart watch that helps me keep track of my BGLs without needing to use my phone (love it!).
If my BGLs drop during a game, I’ll either drink a Powerade or I’ll have the 95 cent jelly pouches from Woolworths as they are very easy to consume (highly recommend!).
And what do you do after exercising?
After a session of tennis, because I usually haven’t had any insulin for around two hours, I’ll administer between 0.5 and 1.0 units of insulin. I also tend to eat more afterwards to account for the increased insulin sensitivity.
In the evening, I’ll usually use the “ease-off” function on my pump for the first 3 hours of sleep, as my BGLs tend to run low after a tennis session.
Do you have any advice for people with T1D who want to start exercising or do more of it?
It really helps to know at least 1 hour in advance if you’re going to exercise.
You can adjust your basal accordingly in advance, and if you’re having a meal prior, you can decrease your bolus amount too.
The problem comes with spontaneity. And there’s not much you can do about that if you’ve already administered insulin and then decide to exercise. You just have to eat more food unfortunately!
Any other tips to share?
Use the data you have at your fingertips (CGM readings + insulin doses + carb intake when bolusing) to help you to identify trends.
Read and listen to what other T1Ds do, as you can get some tips you may never have thought of yourself.
However, it’s important to remember that everybody is different. What works for someone else may not work for you.
