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insulin pump and exercise

When it comes to exercise, the principles of insulin dosage are fairly similar regardless of whether you use MDI therapy or pump therapy.

The insulin pump facilitates insulin dosing during and after exercise. It is easy to increase or decrease insulin dosing with the pump as needed. Changes in the basal dose are reflected in blood insulin levels within about an hour.

The effect of exercise is always individual and depends on the type of exercise (aerobic or anaerobic) and its intensity. The best way to learn how to manage diabetes and exercise is through trial and error and observing how different types of exercise affect your own diabetes. Below are some basic guidelines for exercising with a standard pump and a smart pump.

In the standard pump, the basal rate can be reduced to half about 60–120 minutes before planned exercise and continue for the duration of the exercise. If necessary, the pump can be detached for 1–2 hours. During the night after exercise, the basal rate can be reduced by about 20 percent for 6–8 hours. Those who exercise regularly can create a different basal insulin program in their standard pump for use on exercise days and the subsequent night.

With a smart pump, one prepares for exercise by setting a temporary higher blood glucose target in the pump 1-2 hours before exercising and, if necessary, also after. If blood glucose rises after anaerobic exercise or HIIT training, the temporary target can be scheduled to end right after the exercise and, if necessary, take correction insulin.

The same principles apply to taking mealtime insulin doses or boluses during exercise as with MDI. If exercise occurs within two hours of a meal bolus, the dose is reduced based on experience. The reduction is often 30–50 percent, depending on the individual and timing of the exercise.

Updated 4.11.2023