Paul Coker & Rachael Hunter Dunn – Diabetes & Swimming; Managing Blood Glucose Levels Before a Swim

I’m really excited. I’m sitting here in Brighton today with Rachael Hunter Dunn. Rachael is a friend of mine. I met her about three years ago at the Animas Sports Weekend when we were both learning the foundations of how to exercise with diabetes. Rachael does some incredible open walk to swims for incredible distances, and today I will be asking Rachael about how she manages her blood glucose levels.

Rachael, how long have you had Type 1 Diabetes?

Since 1998, so a very long time.

I’m guessing that you started out using insulin injections.

Yeah. I was taking four injections a day, so breakfast, lunch, dinner, and then one before bed.

Okay. I believe that you’re now using an insulin pump. Do you find that makes it easier for you to do exercise?

It's been amazing actually. I've been on an insulin pump for about five years, but then my career changed and I started to coach swimming so I managed to get a waterproof pump, which really has helped me continue my job and also manage my diabetes whilst working. It's been amazing and it's so specific in the levels that it's really much easier to control than being on injections.

One thing that’s always been a challenge for me is actually keeping my insulin pump on whilst I swim, so how do you manage that? To start with I never had a waterproof pump, which I now do have, but I always found that the cannulas came off whilst I was in the water for any length of time.

Do you have any special techniques or secrets to share?

No real secrets, but I have ... You can get some wipes which make it easier to stick to your skin. I don't really have a problem with such. I mean, I change my cannula every couple of days anyway. I haven't really had a problem with it coming off, only if I've been in a hot country ... when you're sweating and your skin's, all that's sticky so yeah. I haven't had a huge problem with that.

Okay. Are there any special measures that you take for your diabetes before you go for a swim?

It depends on how long I'm going out for. I do a lot of cold water swimming, which I find that affects my blood glucose levels so it really depends if I'm doing cold water swimming or if I'm going out on a longer distance swim. For example, I did my longest swim, which was eight kilometres, I did that in earlier this year in May. Before the big swim I took on a lot of carbs the night before. The good thing about the insulin pump is that you can reduce the basal rate of insulin going in so I did a temporary basal rate, set that a couple of hours before swimming, and set it to a couple of hours after you finished as well. I find that really was useful.

You were talking about cold water swimming and you were saying that affects your blood glucose levels. What happens to your blood glucose levels in the cold water?

I find that my blood glucose tends to rise, maybe half an hour to an hour after I've come out of the water, so you have to ... It's a little bit tricky to manage. Like I said, before, it depends how long you're going in for. Sometimes I don't react to it, but other times you just have to bring your sugar level down a bit.

The blood glucose level increase, does that tend to happen more after you’ve done a longer cold water swim?

Well, I don't actually go in for that ... Say, for instance, the eight kilometres I did in Nansroty, that wasn't a cold water swim. It was a nice temperature. Although you do start to feel cold, but in terms of swimming in February where it's six degrees, that's where I wouldn't be in for more than 10 to 15 minutes. Obviously, the 8K that I did, that was in warmer waters.