RCH logo

Diabetes at the RCH

Pump therapy: exercise

  • Children and adolescence should be accumulating 60 minutes of moderate to vigorous exercise per day. Sedentary behaviour (like screen time) should be minimised every day to no more than 2 hours. Generally, exercise has an effect on your insulin needs and your response to exercise can only determine by monitoring BGL’s. Glucose levels may be impacted by type of activity (ie anaerobic vs aerobic) duration of activity and even the time of day.

    Generally exercise lowers blood glucose levels both during and after the activity (although sometimes interval-style exercise can elevate BGL’s in the short term). A decrease in BGL’s may occur many hours after sustained exercise and therefore, monitoring levels later in the evening and overnight is important

    Do I need more food or less insulin? – You may need both

    Below is a guide of different ways in which to manage your exercise regimen depending on the pump you are using and the mode in which you are using it. 

    Hybrid Closed Loop (HCL)

    Manual Mode

    Set temporary target (Medtronic), Exercise Activity (Tandem) or Easy-off mode (Ypsomed) 1-2 hours prior to activity.

    You may need to remain in the above setting 2-3 hours after the activity to reduce the risk of post exercise hypoglycaemia.

    Eat 5 – 15grams of low GI carbohydrate without a bolus. Pairing this with a small amount of protein (e.g. Greek yoghurt OR biscuits and cheese OR ½ peanut butter sandwich) 

    OR

    Set a reduced temporary basal rate 1-2 hours prior to exercise. You may need to remain in this rate after the exercise to reduce risk of post exercise hypoglycaemia.

    OR

    A combination of both

    General guidelines:

    • Monitor BGL before, during and after activity to see the effects
    • High intensity exercise can affect BGLs for many hours afterwards
    • Disconnect the pump for contact and water sports. The pump can remain disconnected for a maximum of 90 minutes. After 90 minutes you must reconnect the pump and receive a bolus (either for food consumed or 1 hour worth of basal insulin). Once insulin has been delivered, the pump bay be removed for a further 90 minutes.
    • Do not correct high BGL’s within the hour prior to or post exercise.
    • If using HCL, it is not recommended to consume a low GI snack. This is because the pumps algorithm will begin to give additional insulin as it notices a rise in sensor glucose. If hypoglycaemia is still occurring despite the use of temp target/exercise activity/easy-off and a pre activity snack is recommended, please ensure the pump is disconnected prior to consumption. 

    Page updated September 2024