Objectives: To determine the efficacy of reductions in long acting and basal insulin to prevent lows in T1D sports campers. The Sam Fuld’s T1D Sports Camp is a camp for children with T1D taking place each February. It involves high-intensity exercise for up to six hours in a day. We began adjusting our insulin dosing recommendation in 2017 to prevent incidence of hypoglycemia and ensure more campers are able to fully participate.
Methods: We compared incidence of hypo and hyperglycemic events at camp from 2016-2019. Using bg data recorded for all T1D campers. Starting in 2017, we recommended MDI campers decrease long acting insulin by 30% the night before camp and pump users decrease basal rates by 30% beginning at breakfast prior to camp. In 2019, meal boluses for lunch were also cut by 50%.
Results: From 2016 to 2018 there was a 40% decrease in campers with low bgs, and an expected increase in hyperglycemic values. In 2019, we saw an increase in lows compared with 2018 with lower overall prevalence than seen in prior years and fewer hyperglycemic events than in 2018.
Of those campers who followed the recommendations, in 2017, no incidents of hypo or hypoglycemia occurred, in 2018 there were just three incidents of hyperglycemia and in 2019, one bg value < 50 mg/dL and 8 bg values > 250 mg/dL (mostly in the morning).
Conclusion: More research is needed to determine the best dosing guidelines for intense exercise in children with T1D.
A.M. Terry: None. S. Bollepalli: None. L. Smith: None. H. Rodriguez: Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Daiichi Pharm Corp, MannKind Corporation, Medtronic MiniMed, Inc. Research Support; Spouse/Partner; Medtronic MiniMed, Inc. Research Support; Self; Takeda Pharmaceutical Company Limited. Other Relationship; Self; Merck & Co., Inc., Novartis Pharmaceuticals Corporation, Novo Nordisk Inc.