Equestrian Events

OK, we have now gone seriously up market here, but the lessons from polo are applicable to all equestrian events. Please send any other horsey content!
Polo
Miss K.L. is a 30 year old sportswoman with type 1 diabetes of 20 years duration She is a keen polo player. I do not know very much about polo but she told me that she competes in matches that last for approximately an hour in 7 minute sessions. She rates this in physical intensity of about 9/10. She also trains for polo with horse riding for an hour in time for which she rates about 6-7/10. She does daily gym work for an hour which equates to physical intensity of 4-5/10. She is taking approximately 100 gm of carbohydrate per day. She did not bring in any records of her blood glucose monitoring today.

During her sporting events her blood sugars drop dramatically from 10 down to 3-4 during an hour’s polo match. She also notices a marked loss of performance towards the end of these matches.
Management Plan
1. She needs to check her blood glucose before and 2 hours after each meal; so that she can make sure that her carbohydrate counting and the correction values are correct.
2. She also needs to check her blood sugars before and during sporting events so that we work out the rate of decline in her blood sugars. This could be ameliorated by taking extra glucose in the form of drinks, Dextrosol or even jelly babies, but it may be added to by her Lantus. If there is evidence of this then we should consider transferring her onto pump therapy.
CGMS monitoring looks like this.

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