My 15 year son was diagnosed with type�1 diabetes three years ago and has been on a pump for about four months. He is playing baseball as a catcher and loves to steal bases. So far, he’s taken the pump off at practice, and his blood sugar has been low or in the normal range afterward. Any good spots for a pump? Should he just leave it off for the two hours of ball, check his blood sugar frequently, and back up with shots if high?

The fact that your son is wearing an insulin pump gives him lots of options. As a suggestion, during play the pump itself can be worn comfortably on the waistband in the area of the lower back. To maintain stable blood glucose levels, generally partial replacement of the basal rate is needed when disconnected from the pump for longer than an hour, even during exercise. If the infusion site is easily accessible, this might simply mean reconnecting after one hour, providing a partial bolus to cover the missed basal rate, and disconnecting again. This procedure can be repeated as needed and adjusted based on blood sugar levels. Practice is usually a bit more active than game time, thereby requiring less insulin. Based on the blood sugar numbers you are seeing, this appears to be so in your son’s situation. Recognize that you may see a slightly different response on game day but can adjust accordingly. Talk to your son about his preference and to your healthcare team about the options.

DMW