Insulin Pumps and Exercise: Interview with Linda Franklin

After an inspiring interview with Kyle Cochran, American Ninja Warrior finalist, about why he chooses to use an insulin pump and how it helps him when exercising, I really wanted to ask the same questions of someone inside our own Facebook community. Sometimes it’s useful to hear from a person who has a lifestyle more like mine.

Meet Linda! Linda was diagnosed with type 1 diabetes in July 1982, when she was 26 years old. She has been wearing a pump for over 15 years and now also uses continuous glucose monitoring (CGM). Here she gives me the lowdown on why she chooses to use an insulin pump, and how it helps her manage her diabetes.

Linda’s athletic accomplishments include:

• National Gold Medal/Leading Goal Scorer – Women’s Soccer/National Senior Games Association 2009
• 2 State Gold Medals/1 Bronze Medal – Women’s Soccer/Bay Area Senior Games
• 2014 CrossFit Open – 40^th Worldwide, Masters Women 55-59 (age 58)

This post was written in collaboration with Tandem Diabetes Care as part of their sponsorship of the Strong With Diabetes Challenge

When did you get an insulin pump and why?

I didn’t even know about insulin pumps until 2001 when I started seeing a new endocrinologist. I was frustrated with having to spend time on the sideline dealing with low blood sugars rather than running around on the soccer field, so when she suggested the pump, I asked to get hooked up immediately. I was excited to learn that I would finally have the freedom to exercise and participate in sports with more spontaneity after 19 years of having to schedule my activities around 6-8 daily insulin injections.

I recently switched to a t:slim X2 insulin pump. I made the switch because the t:slim X2 has the ability to allow me to add new features through a remote software update in the future, no matter how much time is left on my insurance cycle.¹ Another reason why I went with the Tandem pump is that it has a touchscreen interface, so no buttons. I have tendonitis, so button pushing was challenging for me.

What do you think are the top 3 benefits for you of an insulin pump when it comes to exercise?

1. The flexibility of adjusting basal rates based on different types of exercise – I play soccer, lift weights and run 5Ks. With soccer and weightlifting, I increase my basal rate and usually bolus before with a small snack which keeps me from spiking. I decrease my basal rate when running.
2. The ability to adjust my basal rate also allows me to take part in unplanned physical activities, like going for a walk or playing with my dog on the beach without worrying as much about hypoglycemia.
3. It does the math for you! I love being able to enter my blood sugar and carbs, if needed, with the push of a few buttons. It calculates the amount of insulin needed to correct a high blood sugar from an intense soccer game or heavy weightlifting. Because it calculates insulin-on-board, it helps prevent me from accidentally stacking insulin – yay!

Are there any particular activities that require special accommodations for your pump?

I’ve just taken up water sports, and since the pump isn’t waterproof, I disconnect it before going in the water. Tandem pumps are watertight², so I have peace of mind knowing that my pump is safe in the event of accidental submersion. However, it’s not recommended that you shower, bathe, or swim with your pump. It’s important to make sure you’re replacing at least a portion of missed basal insulin if you plan to be disconnected. My experience is that it hasn’t been a problem – I just disconnect and do a bolus correction or increased basal when I get out of the water.

Oh, and if I go dancing, it can be a little hard to find a place for the pump if I’m wearing a dress. I know you can “hide” it a few places, but I like to have easy access to it so I can see my insulin-on-board on the screen. I make it work, though!

How do you prevent hypoglycemia during exercise?

About 30 minutes to 1 hour prior to steady exercise I use the temp basal feature to lower my insulin –anywhere between 20% to 75% of normal – depending on what my blood sugar is and whether or not I have a snack. At the end of my run, I turn the temp basal off. And last, but not least, I always carry snacks.

I pay attention to trends and make small adjustments when trying to figure out how much to increase or decrease my doses. A lot of it is trial and error. I’ve found Gary Scheiner’s book, “Think Like A Pancreas”, incredibly useful in helping me gain the knowledge needed to make these decisions.

What would you say to anybody who’s nervous about starting on a pump?

For me, switching over to a pump was a life-changing decision, so I of course encourage anybody to give it a try. I know that some people are concerned about the tubing and having something attached to their bodies 24/7, but I am really not bothered by it. Think about it – you carry your phone with you everywhere, and I don’t think this is much different. At least for me, it quickly became second nature. It’s an extension of me now.

Finally, if in doubt, reach out to other people living with diabetes (like here on Diabetes Strong and in the Facebook group) and ask about their experiences. Everybody’s preferences are different, but the pump is definitely the right choice for me and my lifestyle.

How did you learn to use the pump?

Back when I started on my first pump, I saw a diabetes educator who taught me the ins and outs of pump therapy. Getting started on the Tandem pump was extremely easy for me. Now, I’m pretty much self-managed.

I have called Tandem’s 24/7 tech support a few times when I’ve had questions. In general, I think people underutilize pump companies’ support lines. In my experience, Tandem’s support specialists have a wealth of knowledge and are more than happy to help. Many of them even have diabetes themselves!

To learn more about insulin pumps and to check if your insurance will cover one, go to Tandemdiabetes.com.

Disclaimers

¹ Software updates and new features are not currently available for the t:slim X2 Pump and are subject to FDA approvals. Charges may apply. (UPDATED: On 8/28/2017 Tandem announced FDA approval and launch of the t:slim X2 Insulin Pump with Dexcom G5 Mobile CGM Integration. Additional software updates and new features are subject to future FDA approvals. Charges may apply.)

²Tandem pumps are watertight (IPX 7), tested to a depth of three feet for up to 30 minutes.

From time to time, we may pass along: suggestions, tips, or information about other Tandem Insulin Pump user experiences or approaches to the management of diabetes. However, please note individual symptoms, situations, circumstances and results may vary. Please consult your physician or qualified health care provider regarding your condition and appropriate medical treatment. Please read the Important Safety Information before using a Tandem Diabetes Care product.