Skiing trip with school and Type 1

[Liltzero]

Hi there - my daughter is going skiing with the school next week (she is 13) and I wondered if anyone had any tips on ski-ing trips generally with T1D and an omnipod 5 pump/Dexcom CGM or thoughts on important aspects to make the school aware of (apart from the obvious).
So far I am ensuring there are multiple sets of spare sensors, pods and a spare PDM and have met the school to talk them through everything. They will get the CGM data on a school mobile but I wondered if there were any tips others had?

And to the ski-ers out there - do you find you go low in the evenings when you relax and warm up?

Thank you!

 

[Lily123]

Hi @Liltzero

It sounds like you’ve got everything sorted.

Have you got one of the teachers going on the trip trained in how to use glucagon? It will hopefully be unnecessary but it’s better to be safe than sorry.

 

[Liltzero]

Hi @Liltzero

It sounds like you’ve got everything sorted.

Have you got one of the teachers going on the trip trained in how to use glucagon? It will hopefully be unnecessary but it’s better to be safe than sorry.

Hi there sorry for the long pause. Unfortunately the skiing has been a nightmare as her levels just keep dropping like a stone and she can’t get enough sugar even with lots of amendments to her pump settings. She is currently trying to suspend when it gets below 8 but this is far from ideal! Also I have stopped receiving data from her Dexcom and I can’t work out why.
I think the skiing would be fine if we were there but it’s too difficult and scary as we’re not there and with the best will in the world the teachers can’t handle the complexity. On top of everything she is cross with me because I keep hassling her all the time!!
Anyway, if anyone else is thinking of allowing their type 1 child to go on a school ski trip, I would advise against it as it doesn’t feel safe to be honest

 

[Inka]

Is she using a temporary basal rate for her skiing @Liltzero ? I’m sorry she’s having trouble. That must be very stressful for you both.

 

[Liltzero]

Hi yes she tried with half the normal basal rate but that was still too much and didn’t stop before she got low Thanks for the kind support 🙂

 

[Inka]

I usually put a basal rate of 10%-20% for energetic activity @Liltzero Sometimes I have to eat some glucose too but I find that a good compromise. I hope it hasn’t put her off and that she still enjoyed her trip.

 

[Liltzero]

Oh really? That might have worked better. I don’t really get why activity mode on the pump hasn’t worked very well. Seems not really fit for purpose?
She does do a lot of intense exercise here but it’s never more than two hours and not in the freezing temperatures with not so much food ( as it’s not great at the hotel apparently) I think the problem is trying to make the changes with her while she’s skiing and not being there. Perhaps we should have taken her skiing ourselves before letting her go with the school. Oh well all good learnings….

 

[Robin]

She does do a lot of intense exercise here but it’s never more than two hours and not in the freezing temperatures

Another thing I find makes a difference is unaccustomed high altitude. The body is working harder generally (whether during exercise or at rest) until it acclimatises after a few days. I don’t ski any more now, but I do walk in the Alps in summer, and I always have to drop my basal massively for the first few days.

 

[Liltzero]

Ahhh that might be a big factor then as she was not too bad on the nursery slope but the problems set in when they went up into the mountain. Thanks for all the info- really helpful as I have been at a loss to know what has happened!! And helpful to know for the future

 

[Liltzero]

Ahhh that might be a big factor then as she was not too bad on the nursery slope but the problems set in when they went up into the mountain. Thanks for all the info- really helpful as I have been at a loss to know what has happened!! And helpful to know for the future

Do you find it problematic on flights too then? Or is it ok because you’re just sitting down? We’ve not flown since she was diagnosed. Thank you!!

 

[helli]

Do you find it problematic on flights too then? Or is it ok because you’re just sitting down? We’ve not flown since she was diagnosed. Thank you!!

Airplane cabins are pressurized so you do not experience the high altitude.
Flying does not affect BG but things like sitting down for a long time (on long haul) or feeling stressed about flying may.

 

[Liltzero]

Ok - whoops! Didn’t realise. But thanks- really helpful insight. So many unexpected factors that affect glucose levels

 

[SB2015]

Oh really? That might have worked better. I don’t really get why activity mode on the pump hasn’t worked very well. Seems not really fit for purpose

I find for exercise I need to set the change in my basal insulin about 2 hours before I start (a temp target on my pump) and also reduce the insulin for carbs before and/or during . The changes each of us need vary and if 50% hasn’t worked it sounds like your daughter needs a bigger reduction.

How long has she got before the trip? It should be possible to manage the trip with a bit of help. Has her PDSN been helping? They will have plans for dealing with the altitude and change in temperature.

 

[Leadinglights]

I find for exercise I need to set the change in my basal insulin about 2 hours before I start (a temp target on my pump) and also reduce the insulin for carbs before and/or during . The changes each of us need vary and if 50% hasn’t worked it sounds like your daughter needs a bigger reduction.

How long has she got before the trip? It should be possible to manage the trip with a bit of help. Has her PDSN been helping? They will have plans for dealing with the altitude and change in temperature.

From the earlier posts it looks as if she is actually on the trip at the moment, Probably because it is half term.

 

[helli]

I find for exercise I need to set the change in my basal insulin about 2 hours before I start

This will depend on the insulin you use and how it works for you.
For example, I would need to set temp basal an hour before exercise for NovoRapid but only 30 minutes for Fiasp.
Plus it depends on current BG when setting it.

 

[Inka]

Oh really? That might have worked better. I don’t really get why activity mode on the pump hasn’t worked very well. Seems not really fit for purpose?
She does do a lot of intense exercise here but it’s never more than two hours and not in the freezing temperatures with not so much food ( as it’s not great at the hotel apparently) I think the problem is trying to make the changes with her while she’s skiing and not being there. Perhaps we should have taken her skiing ourselves before letting her go with the school. Oh well all good learnings….

I don’t have the iPod so I can’t comment on that. On my pump (Dana i) I’d just reduce the temporary basal rate to 10% probably the first day out to see how it goes. If your daughter’s looping with her Omnipod, then I’d have turned the loop off frankly and done it all manually, maybe putting the loop back on once off the slopes.

 

[Liltzero]

I don’t have the iPod so I can’t comment on that. On my pump (Dana i) I’d just reduce the temporary basal rate to 10% probably the first day out to see how it goes. If your daughter’s looping with her Omnipod, then I’d have turned the loop off frankly and done it all manually, maybe putting the loop back on once off the slopes.

Thanks all- yes you’re right she is on the trip at the moment and arriving home soon. She did end up turning things off and doing it manually but it was trick to get it right and turn it back on at the right time to avoid being really high at lunch and getting big crashes afterwards etc etc . Was so difficult especially with teenage strops added in to the mix! Luckily I don’t think it has put her off skiing but it definitely did me!!

 

[SB2015]

Thanks all- yes you’re right she is on the trip at the moment and arriving home soon. She did end up turning things off and doing it manually but it was trick to get it right and turn it back on at the right time to avoid being really high at lunch and getting big crashes afterwards etc etc . Was so difficult especially with teenage strops added in to the mix! Luckily I don’t think it has put her off skiing but it definitely did me!!

So glad that she went and that she is not put off skiing.