Teenage Boy - Multiple Sports

Our son just finished high school where he played three sports - football, basketball and baseball.  He's now heading to college to play football and baseball along with intramural basketball.  He was diagnosed as T1 two years ago and put on Januvia in addition to Lantus and Humalog.  He now takes 16 units of Lantus once a day in addition to the Januvia but we've found when he practices every day and eats protein and fat equal to at least half of the carbs he's eating, he doesn't have to use the Humalog.  If he's between sports and exercising less or eats carbs with little protein or fat, he needs Humalog on an 80 to 1 ratio.  And, no matter what kind of exercise he does it always reduces is BG levels.  For the past two years he has used about 12-20 units of Humalog a month.

Have any other athetes experienced this?  His doctor thinks he's still producing some of his own insulin and the Januvia stimulates that while the lack of body fat and extreme exercise keeps his BG low.  His A1c goes between 5.6 and 6.2. 

It's likely he's still making insulin.  His high level of physical fitness probably makes him super sensitive to insulin (as illustrated by his carb ratio of 1:80, that's usually a level you see in a little kid).  But because he's in good shape his muscles are super efficicient so he doesn't use as much glucose as someone who was out of shape.  

Whatever he's doing sounds like it's working.  That's great!!!  Hope he like college.

That's what his doctor thinks.  We caught the diabetes early.  The first day out of the hospital he went low although the diabetes educator told us it wouldn't happen for months.  His doctor knew within a week he was still producing insulin, especially early in the day.  He tried to get him into a drug study but they wouldn't take him because he was under 18 so he put him on the medication himself.   Just wondering if any other athletes out there have had the same experience.

That is exactly what happens to me. I take 0.5 units of Lantus when I'm running regularly, and 1-1.5 when I'm not. Exercise makes your body more sensitive to insulin, and makes the honeymoon stage last longer :)

@ Mal - do you change your Lantus on a day-by-day basis?

I sometimes do if I haven't run for a day and know that I won't be running the next day because that kind of exercise makes my BS lower all day the next day.

We've tried that - we've just adjusted the Humalog and kept the Lantus and Januvia the same every day.   How much regular insulin do you use a day and how long have you had T1??

My insulin to carb ratio is 1:35 during the day and 1:45 at night (extreme honeymooning) and I was diagnosed 1 year ago.

Our son is just the opposite.  He needs no fast-acting insulin until about 3 or 4 in the afternoon.  Up until then his BG is fine.  It just seems like his insulin production cannot keep up as the day goes on so if he overeats on carbs without protein and fat so he'll have to take 2 or 3 units - that's when he goes 1 to 80-100.  His A1c has been improving and his Lantus has gone down over time - started at 24 and now using 16 per day.  His doctor doesn't think it's a honeymoon since his A1c has steadily improved instead of increasing and it's been two years now.   His doctor recently added 500 mg of metformin to see if that helped him.

I play multiple sports as well and I have also had my share of lows on the softball and soccer feild as well as on the volleyball court. My coaches know when there is something wrong because they say "I act funny". Its always a god thing to let your coaches and even your room mates know what is going on with your sugar because if there is an emergency then you have backup. I wish your son luck!

Our son is now a senior in college where he’s playing two sports (instead of the three he played in high school). He is still using the same amount of insulin he did when he was first diagnosed almost five years ago. His A1c throughout college has ranged from 6.2 to 6.9. He continues to take Januvia and Metformin along with Lantus and Novalog (10-20 units a day) and is still on an unlimited diet. I just read that a study is starting on newly diagnosed diabetics using vigorous exercise to see if it preserves existing beta cells. Maybe that’s what happened to our son. When he was diagnosed, he was exercising two, three, even four hours a day. Now, in college, it’s less, but he still does yoga, runs, swims and of course, goes to his football and baseball practice. For five years, we’ve looked for other diabetics like him. He can’t wear a pump because he has to test every time before he gives himself insulin since he never knows when his own beta cells will kick in with insulin. He usually runs from 80 to 200 - very few highs; more lows. He has no other medical problems except the thyroid problem from when he was first diagnosed - whatever went after his beta cells totally destroyed his thyroid function.