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9 Responses

  1. Stacey Simms
    Stacey Simms June 23, 2012 at 4:41 am | | Reply

    Wil, Great info as always. Every time I read one of your columns, I want to call you up and ask more questions. So well written and love your sense of humor. Thanks for all you do to get diabetes info out there!

  2. Kristin W
    Kristin W June 23, 2012 at 7:04 am | | Reply

    I seond Stacey’s comment! I love reading what you write, not only bc it is always informative (without insulting our intelligence or being blameful), but also because it is so well-written. Thanks for sharing yourself, your wit and your knowledge with us!

  3. Tim
    Tim June 23, 2012 at 8:56 am | | Reply

    The only thing I regret about the written word is that there’s no way graphically to signify sarcasm without resorting to CAPS. Great column as always. We can feel free to ask you anything, because the only stupid question is the one that isn’t asked.

  4. Anne Findlay Dowling
    Anne Findlay Dowling June 23, 2012 at 2:43 pm | | Reply

    personally, I do not recommend disconnecting from the pump during exercise especially extended exercise. There may be some, even many, people who can get away with this (or have to do this to prevent lows, especially those that may still be producing some insulin). But I have found having some insulin going + eating appropriately leads to better performance during exercise. I believe I became ketotic during an ironman race once because I had suspended my pump for so long. BGs were normal but I had no circulating insulin. I felt tremendously better once I had some insulin going again…

  5. Cara
    Cara June 23, 2012 at 4:07 pm | | Reply

    I think it’s downright irresponsible of a doctor to discourage a patient from seeking a specialists opinion. :( I’m sad for people that this happens with.

  6. Mary Dexter
    Mary Dexter June 23, 2012 at 4:38 pm | | Reply

    The problem with disconnecting is remembering to reconnect. However, if I use a temp basal that makes my basal = 0, it is essentially suspended but will automatically resume within a given time. Remember to do this before you get to the gym, not right before you start exercising.

  7. Roger
    Roger June 25, 2012 at 8:36 am | | Reply

    Hi Wil. Great post! However, I would like to make a comment on your mention of insulin being the only path for glucose to enter cells. I am currently finishing my MSc in exercise science and am a type 1 diabetic. It isn’t insulin that provides the route for glucose to enter cells, it is the translocation of glucose transporter proteins, specifically GLUT-4 which permits glucose to enter. This process of translocation of GLUT-4 is stimulated by 2 known ways. 1. through insulin signalling where insulin binds to insulin receptors and triggers a signalling cascade to cause GLUT-4 to move to the periphery of the cell and bring glucose through the cell membrane and 2. exercise, specifically the mechanical stimulation of muscle cells also triggers GLUT-4 to translocate, independent of insulin. Now I don’t know of any cases of type 1′s living without exogenous insulin, nor would I recommend anyone try. But just wanted to let you know that, although in most situations insulin is required for glucose to make its way into skeletal muscle, exercise also stimulates uptake of glucose without insulin.

  8. Brian
    Brian August 9, 2012 at 4:38 pm | | Reply

    Very good diabetes intell. I have been T 1 for 27 years and I picked up some knowledge. I am now pumping and will never go back to the other way.

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