My 10 year old son is type�1 and has been on the pump for the past six months. He had a hypoglycemic reaction during the night when his blood level was fine before bed. Is it possible his activity level from six hours earlier could have caused this to happen?

It is quite possible that your son’s activity level from six hours earlier may have caused hypoglycemia during the night. Remember that exercise (especially high intensity or long duration) can increase metabolism for hours afterwards. This can trigger low blood sugar due to the increased glucose utilization and the resultant abundance of insulin. Many insulin pump users who exercise or are extremely active in the evening find success in using a lower temporary basal rate for the hours after the activity. The duration and degree of that lower rate will be extremely individual and may require a bit of work (frequent monitoring and patterning) to find what works best in your son’s situation. For others, a well planned carb/protein snack prior to bed (without a matching bolus), is the chosen option. Talk to your son’s healthcare team about applying these ideas to your son’s diabetes management, and three cheers to you for your diligence!

DMW