It's the sunny and hot season - which means that Cassie has switched to shots instead of the pump. Our kitchen is littered with used syringes and we're quickly filling up the gallon jug that we use to dispose all our "sharps" and needles.*
One reason she likes to be off the pump is because (say this in the voice of Isaac Mizrahi), "It simply ruins the lines of my summer wardrobe." To the mortifying chagrin of a teenager's father, this means bikinis and short-shorts.
But a another valid reason (and easier to swallow for a dad) is that the pump gets in the way of summer sports- tennis, swimming, etc. These activities usually required us to take off her pump for hours at a time. Her mother and I often wondered if we should pre-bolus for the insulin she'd miss from her basal or simply bolus after the exercise. We tried both ways with varying results and came to no conclusion.
Thankfully some real scientists have been trying to answer this same question.
A study done by Milan University revealed that the best glycemic control was achieved by keeping the pump active and on the child athlete then reducing the basal insulin rate by 20% for the two to four hours after exercise, if warranted.
According to a more recent pump study done in Stockholm, scientists found that athletes who did not have the pump on during activity were able to maintain a relatively "good" glycemic index after exercise. Pre-bolusing BEFORE the activity could potentially do more harm than good. The researchers found that if you had to take the pump off for exercise, they recommended "suspending the pump with 20% to 30% temporary basal added for the two to four hours after exercise."
The research was done on a relatively small group of kids - 15 to be exact - so your results may vary.
*It's a bit disheartening to see such a large receptacle nearly full, reminding us how many shots it takes daily for her to stay alive.