Playing with Diabetes

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Several years ago I coached a player with Type 1 Diabetes. Luckily her parents were very knowledgeable on the topic, so I did not need to be. That said, I learned from them to pay attention to certain warning signs and then make sure one was nearby in case they were needed. Diet is extremely important, especially on long travel ball weekends. They often packed the items they needed as most concession stands don't offer many good options. The good news is that she played travel ball from 12u through 18u and never experienced any serious problems. Yes, there were times when she would show some warning signs (shaky hands, etc.), but we were always able to act before it got worse. She was also very good about realizing when she was experiencing symptoms and notifying one of us.

You know, with my DD for a while now there would be little things I'd notice and it would always make me go huh...Just seemed like sometimes she'd be moving like a slug or out of it for a lil' bit. Now we figure that was probably why we just didn't realize it.

Last Saturday she had a private tryout and was on fire. Knocking the cover off the ball, alert, quick on her feet. We were asked to come back to a team practice the following day to meet the girls etc., she looked like she had no energy, didn't hit well, not quick on her feet. The difference?....Saturday she was around 180 and Sunday she started around 120 and by the end was 78. She is a catcher so all of this makes me very concerned.
 
May 29, 2015
3,731
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An insulin pump that works in conjunction with the CGM is an amazing thing. It adjusts the insulin dosage based on the information it is getting from the CGM and gives her a constant stream instead of having to shoot fast- and slow-insulins.

We did manual checks and manual needle injections for over a year. My daughter's first pump did not communicate with the CGM, it just gave a steady basil dose and then we would do a bolus when she ate or was high. Her new pumpdoes communicate and adjust ... it is amazing what it has done for her A1C (and peace of mind!).
 
I'm a Type 1 and have coached a young lady who was as well. It can cause some extra worry, but it sounds like she's (and you) have the right approach. The CGM is really the lifesaver in the sports world, I wear a Dexcom but function is the same. As she gets use to her condition she'll start to be able to tell when things are off, but the CGM can give a heads up before it gets to that point, which is invaluable (wish I had it when I started).

With her monitor bluetoothed to your phone you can keep an eye on her during the game without having to constantly ask how she's feeling and making her feel worse or more worried about it. Yes, as others have mentioned, she'll be up, then down, then up and you can drive yourself absolutely nuts trying to chase it, trust me. Then you'll finally get her daily norms dialed in for a few months and outta the blue, you're chasing again even though nothing should've changed. Prepare her for this same thing. Highs make me grouchy, and long term cause problems, but lows are life threatening in the immediate.

Start the day (or game or even practice) a little high if anything, because physical activity can drastically drop glucose levels. Lows for me start with a little jittery feeling, then to pretty shakey, then to profuse sweating with confusion and the shakes bad. The jittery (very slightly) for me is around 70-75, shakey around 60, sweats starting around 50. My experience is even after getting my sugar back up, I'm cold and tired for the next couple of hours after dropping to that 50-55 level. I can approximate what my level is based on how much of these I'm experiencing, but she won't be able to yet. My CGM (I'm sure hers will do the same) can be set to not only alert you to when levels are low, but also when it predicts a low in the near future. Mine will literally say "low glucose in 20min", and I know that if I don't do anything it will be. I make small adjustments to avoid it.

Always, always, always, have something on hand (in her ball bag, in your car, in her school bag, on her night stand) to bring her sugar up, at least until she's learned what lows feel like coming on. Don't over react by eating an entire box of cookies and three cans of Pepsi, but have something available. Lows can be a little scary (nothing like waking up in the middle of the night at 40 for no reason whatsoever), especially for a kid. It's a little easier after she's gone thru a few of them, and trust me she will, but knowing that something is right at hand if it does takes that fear down a lot. You don't have to spend the extra money on the diabetic blood sugar tabs, just grabs some Skittles, Starbursts, whatever candy she likes. I use Lifesavers for minor adjustments, and a can of pop if I'm dropping faster (chug half then wait 15min and see).

How is she being given insulin, pod, pump, or injection? I'm still injection (my choice) but the young lady I coached was pod (neither of us was ready to be hooked to a pump with tubes and such) due to our activity level.

Please feel free to reach out if you want, I'm happy to offer any insight I can. Best of luck and she'll be okay.

I'm glad she has the CGM now. She's planning on putting it to use this weekend. She's probably sick of me asking or texting her and asking what her level is lol.

With her I think she's more "used" to it being high. Typically when its very high she may seem out of it or have alot of blonde moments. Earlier this week it was down to about 78 and she was complaining of being shakey. The lowest she's been is about 65. Then her only complaint was she was tired.

She carrys a UA mini back pack around with her that has all her stuff with her. She keeps glucose tablets, cake icing, snacks, candy, her monitor, and what ever else she feels she may need.

She's been giving herself insulin via injection. She's much more a champ about it than I think I would be. She gets up in the morning and gives herself the injection, pricks her finger like it's nothing. Like you've said I worry about the tubes etc of a pump especially as a catcher.

Thank you for your advice and insight!
 
Yep, frosting was highly recommend from a fellow diabetic to me as well and I think is a great idea. I did the same thing until I moved to a CGM and also grew more accustomed to understanding how I was feeling. Thinking about it, if it was my kids I'd probably go that route too, wouldn't be my go-to for every situation, but having it could be the difference if they lost consciencness. I still carry a roll of dissolvable tablets in my truck for that same reason.

Dissolvable tablets, that's a good idea. I need to see if I can find some of those.
 
Jul 1, 2019
172
43
Dissolvable tablets, that's a good idea. I need to see if I can find some of those.
CVS and Walgreen's both have them around here, not sure what pharmacy's are in your area but they'll probably have them. Check around the glucose testing supplies. Also, not sure if she's using the insulin pens or literally vial and syringe for injections, if you can try to get insurance to go for the pens. Much, much more comfortable with smaller needle, quick twist to dial in dosage, then insert and press.

With the CGM, one thing I'll recommend (especially with the extra stick cover patches) is a product called TacAway. It's an adhesive remover that helps with the goo left from the CGM (or cover patch) and can even be used to soften the adhesive thru the patch prior to removal, kinda a high powered alcohol wipe. Same company makes SkinTac, a product that applies like a wipe then gets pretty sticky after letting it dry for a few seconds. This is used before putting CGM and or cover patch on for people who have a hard time keeping them adhered for the 7-10 days it's supposed to be worn. I've had mixed results with the SkinTac (I'm also not as active as our DD's and my sensors almost always stay put the full time), but I love the remover.
 
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So I am going to try to go line by line of what you posted and tell you how we did things.
First of all when my dd was diagnosed the CGM was not an option, so she did finger sticks to get blood draws, for a while she was doing them literally every inning so we could see what pitching did to her levels, the cgm is a huge improvement. My dd used injections for the first 6 months which meant in the middle of a softball season she switched to a pump, which while a much better system for her. We had to relearn some things. But its been a great system for her.

First of all, your dd's attitude of its just another challenge is exactly what you want. I applaud your families commitment to your dd managing her own care. Too many parents want to be 100% in charge and never give their kids ownership of the process. Which means when the kid goes to college they are all of a sudden in charge of their health, on top of everything else that's new and going on.

So about the big swings of blood sugar, your dd is probably in what is oddly called the honeymoon stage, where her body is still making some insulin. Unfortunately this is not consistent so sometimes the body dumps some insulin into her system and other times it doesn't. That will give you highs and lows. Eventually her body will stop being able to make any insulin and this will help even out things.

Exercise will naturally lower blood sugar so during activity you might need to change how you dose, your endocrinologist should be able to give you some guidance. if you are using a pump you can actually temporarily change the base settings to slow down the insulin for a set amount of time. My dd would take her pump off for batting and base-running and when she played basketball and volleyball she took it off whenever she was on the court.

We bought all sorts of snacks and beverages with us to games, and tourneys. My dd liked to eat melon between games so we would usually bring some sort of meat or cheese to go with so she had some other food to go with. We also brought trail mix. That gave her some sweets to balance out lows and some more complex carbs to keep her from crashing later. She likes water, so we brought lots of that and maybe a low cal gatorade type drink. We always had a few juice bags for quick treatment of lows. We also had glucose tablets in every bag, car, purse, drawer...

We carried a small cooling pack in a bag to keep her insulin from getting hot.

Remember that in the short term a bad low is more dangerous then a high. Err on the side of high.

My dd is using the same CGM as your dd, she didn't have it until last year. So her competitive sports career had ended. But its been great for her. She has consistently better A1C numbers since she started using it.

This is a thread I started the first year she was diagnosed. There might be some info there.

If you have any questions feel free to ask. You can PM me if you are more comfortable

Thank you so much for the post. I appreciate every bit of it. I'm betting others will too that come here or search for it. Eventually we'd like start her on a pump but I worry about the wire and her catching.

Thanks, she down right amazes me with her determination and resolve to not let this get her down or anything really else for that matter too. She's always been the "easiest" most mature of our three kids. I can tell she worries sometimes, I try to reassure her best I can.

Funny you mention something about the honeymoon phase. That's exactly what her diabetic educator has called it. Yesterday, for whatever reason she was over 400 most of the day (trying a different long term insulin) then late last night it dropped to 124. She said well I guess my pancreas finally woke up lol.

On days she has had school ball or travel ball practice she's adjusted her dose so she wouldn't go too low. Seems like running is what really does it for her. Drops it like a rock. It worries me for this summer as she's sweating in the NC/SC heat catching.

Funny thing is I've never been one to haul around one of those wagons and a cooler but I guess that's about to change. I'm thinking of making sure we have some snacks, protein etc. with us. Trail mix is a good idea. She likes gold fish and cheese its. That's been her go to snack when she needs some snack size carbs. We've been thinking of buying some Gatorade Zeros since there's no sugar in them, and water of course. Also been thinking of taking some of the very small cans of soft drinks for if she gets very low.

If you don't mind what kind of small cooling pack did you use for the insulin? That's a good idea and something I was wondering.

Again thanks!
 
CVS and Walgreen's both have them around here, not sure what pharmacy's are in your area but they'll probably have them. Check around the glucose testing supplies. Also, not sure if she's using the insulin pens or literally vial and syringe for injections, if you can try to get insurance to go for the pens. Much, much more comfortable with smaller needle, quick twist to dial in dosage, then insert and press.

With the CGM, one thing I'll recommend (especially with the extra stick cover patches) is a product called TacAway. It's an adhesive remover that helps with the goo left from the CGM (or cover patch), kinda a high powered alcohol wipe. Same company makes SkinTac, a product that applies like a wipe then gets pretty sticky after letting it dry for a few seconds. This is used before putting CGM and or cover patch on for people who have a hard time keeping them adhered for the 7-10 days it's supposed to be worn. I've had mixed results with the SkinTac (I'm also not as active as our DD's and my sensors almost always stay put the full time), but I love the remover.

Thanks we have both of those here. She uses the pen. You're right, so much easier.

Good suggestions, I'll see if I can find those. I was thinking about it yesterday wondering about sweat and the sensor. I ordered some cover patches for it, should help I hope.
 
Nov 26, 2010
4,784
113
Michigan
Thank you so much for the post. I appreciate every bit of it. I'm betting others will too that come here or search for it. Eventually we'd like start her on a pump but I worry about the wire and her catching.

Thanks, she down right amazes me with her determination and resolve to not let this get her down or anything really else for that matter too. She's always been the "easiest" most mature of our three kids. I can tell she worries sometimes, I try to reassure her best I can.

Funny you mention something about the honeymoon phase. That's exactly what her diabetic educator has called it. Yesterday, for whatever reason she was over 400 most of the day (trying a different long term insulin) then late last night it dropped to 124. She said well I guess my pancreas finally woke up lol.

On days she has had school ball or travel ball practice she's adjusted her dose so she wouldn't go too low. Seems like running is what really does it for her. Drops it like a rock. It worries me for this summer as she's sweating in the NC/SC heat catching.

Funny thing is I've never been one to haul around one of those wagons and a cooler but I guess that's about to change. I'm thinking of making sure we have some snacks, protein etc. with us. Trail mix is a good idea. She likes gold fish and cheese its. That's been her go to snack when she needs some snack size carbs. We've been thinking of buying some Gatorade Zeros since there's no sugar in them, and water of course. Also been thinking of taking some of the very small cans of soft drinks for if she gets very low.

If you don't mind what kind of small cooling pack did you use for the insulin? That's a good idea and something I was wondering.

Again thanks!
The cooling pouch we used, I think we picked it up at CVS. Ask the pharmacist they will know.

As for the pump and catching. My dd pitches with hers and caught a few innings here and there. But if she goes low when
She excercises she can take it off. The onset is designed so that the pump can be disconnected without pulling out the port. So she can snap it on and off. As was mentioned before you only use one type of insulin with the pump and it’s the fast acting one so taking the pump on and off for short periods will quickly adjust where she is.

The pump isn’t for everyone and if it doesn’t work for your dd, you can be sure that she (and you) will become experts in manipulating carbs and dosages to keep those lows at bay. Eventually your dd will be a walking encyclopedia of carb knowledge and will know from looking at a pile of rice pilaf how many carbs it contains. It gets better.
 

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