things that cause lows (cold weather camping)

[cshoresal]

A: camping, cold, increased level of activity
Q: what kinds of things can make it tough to keep bg levels up in your dia-kid?

Sorry about this long explanation, here, but I think a little background info is really necessary.

I wasn't in this game when my daughter was a little one, with all that crazy energy they have, so we're still figuring out how various things effect her. She is almost-14 and was diagnosed a little over 3 years ago. Her main "thing" is fife & drum corps, which is basically a music ensemble that plays for many parades and then also at musters. The musters are basically like a giant three-day family reunion, where everyone camps friday and saturday night, the "family" comes from hundreds of miles around, and everyone is a musician. It goes like this:
Friday night tattoo (concert), followed by a jam session that can easily run from 6 or 7pm until midnight or whenever the local sound ordinances require they stop.
Saturday mid-morning parade, usually about a mile long.
All day Saturday after the parade, the individual corps take the stage/stand to perform for about 10 minutes each. This goes on until dinnertime, and then, can you guess? Another jam session until midnight.

This is an all-ages thing. The kids, and everyone else, come and go from the jam session freely, often spending time running around playing games, or sitting around our camp area chatting, or in their tents playing games or talking.

The food is typical camping/bbq type food... Egg & bacon sandwiches for breakfast, sandwiches for lunch, pasta salads, fruit, hamburgers/hotdogs for dinner, sometimes a spaghetti supper type arrangement. Chips and soda, and lots of water.

So, the parades can be tricky. But we've pretty much settled in on what happens there. If she steps off (begins to march) at somewhere in the mid 100's, and reduces her pump basal rate to about 75%, she's usually in pretty good shape at the end. But, she often trends low for several hours afterward. Sometimes for the rest of the day. She's a drummer, btw, so she's not just marching.

The really tough times are the musters. Three days of increased activity, less sleep, cold weather, hot weather, food we don't usually have, and decreased communication between us. (I'm always there at the event, but it's spread out. And we homeschool, so we're usually together otherwise) This past weekend was our first muster of this season. It was in Massachusetts. Temps were in the 40s and low 50s during the day, 30s and low 40s overnight. It rained most of the time, with a steady ccccold breeze. Fun, fun...

Everyone was cold and wet, but still... everything went on as scheduled, though the jam sessions were indoors instead of the usual outdoors.

Matty (my daughter) battled lows the entire weekend. We stuffed her full of carbs, turned OFF her pump several times, and still... well, the worst of it was Saturday night when she hit 24. She stayed conscious, but barely. Several times during the weekend, she was in the 40s. And we had a hard time just keeping her in the 60s. By late Saturday night, it finally dawned on me that she must have been burning up the carbs just trying to keep her body temperature up. Does that make sense? Does anyone have any experience with cold weather camping? I've read about people's ski trips and such, but that is much higher activity levels (though for shorter periods of time), and usually involve large sit-down meals at the beginning and end of the day. If I had it to do over again, I'd have her drinking hot chocolate all day (to keep her a bit warmer, and to keep the carbs coming), and reduce her basal insulin rate to about 25% for most of the daytime hours.

Any thoughts? Suggestions on ways to handle things?
~ Sally

[mysnackrifice]

Every year, my best friend and I go no-tent winter hiking and backpacking for a week along the Appalachian Trail. It does reverse the process. I am pretty sure that this would not be recommended, but when I go out, I start off with a big pasta meal at an Italian restaurant, usually pasta romano with a portabella mushroom on top. I only take half the insulin I normally do. Then in the car on the way there, I pound back the peanut butter sandwiches, still halving the insulin. By the time we get out of the car, I try to be above 240, and then we start hiking. I keep eating nuts and cheese the whole trip, as much as possible, because the fat and protein keeps my sugar high. If I don't start off that way, I end up fighting to keep above 50.

Then while we're on the hike, I take no insulin at all, unless I need it. When we have meals, I eat the meal first, get back to hiking, and then two hours later I test. I usually don't need anything, if I do it's only a unit or two. We usually hike in jeans and long sleeved t shirts because you get hot pretty fast hiking like that, so my sugar is low enough without insulin.

I'll add that age-old disclaimer, I am not a doctor, this isn't medical advice, and it just comes from my personal experience. Your diabetes may vary.