Charlie Rabe, longtime T1D, Level 2 PSIA Snowboard Instructor:
"Typically you have a ton of pockets on your gear. Knowing where your stuff is located can be critical. For that reason, I assign pockets for my diabetes supplies that stay constant through the season. Example: right ‘hand warmer’ jacket pocket is always my candy pocket, or low supplies pocket. Candy pocket just sounds more fun. Also, all the sour patch kid sugar that spills out is confined to that one pocket and the rest stay pretty clean."
Emily George, T1D, skier and graphic designer:
" I reuse a M&M's Minis tube for my low supplies (any kind of candy in there really) for a winter coat. The key difference between this tube and a standard glucose tab tube is the cap is attached. Easy to pop open with a glove on and resealable. No fumbling with taking gloves off and opening wrappers. Also: keep a hand warmer near your pump."
Geoffrey Kruse, Insulin Pump software developer for Tandem Diabetes Care:
"Pumps should be worn as close to the body as possible (innermost layer) to prevent exposing it to extreme temperatures and wind chill. This includes tubing for tubes pumps. The insulin in exposed tubing can freeze pretty rapidly. I’ve seen pumpers who have the pump nice and warm next to their skin but the tubing is hanging out."
Pockets, pockets, pockets
Otherwise, be prepared to carry a backpack with slow AND fast-acting carbs, BG meter, glucagon, testing supplies, etc. Just like fruit snacks can melt sitting in the sun, granola bars and other go-to carb snacks can freeze on the hill. Packets of honey or glucose tabs are great because they won’t freeze like many other fast-acting carbs.
Test at the bottom of the chairlift before getting on
There’s nothing worse than getting on a lift thinking, I’ll test when I get on, and then when you test, and you have a low, you’re stuck on the lift with the chairlift continually stopping and starting. Even if you have the carbs with you on the lift, we tell families at Riding On Insulin that kids must have a BG of 100 or more before they can ride the lift.
Keep your equipment from freezing
This one’s easier said than done. When you’re on the mountain for hours in freezing temps, diabetes equipment doesn’t want to cooperate. Make sure to put your pump and CGM in an inside pocket. Same goes for your Dexcom and meter if you aren’t using a backpack. If your insulin pump tubing is exposed, and it’s cold enough, it can freeze inside the tubing. For this reason, it’s also good to carry a pen of rapid-acting insulin (even if you’re on a pump) just in case you skyrocket above 300 and need to come back down while your tubing thaws out. For tubeless pumps like OmniPod, we’ve found body heat keeps the pump warm enough under your clothing.
Bring spare sites and sensors:
Sites can be accidentally ripped out by literally (almost) anything, including long underwear, brakes on skis, snowboard bindings, jacket zippers, etc.
Temp basal rates:
If you’ve never used a Temp Basal Rate for your pump, talk to your doctor about the best rate for you. Physical activity at a higher altitude means your heart rate is higher; my doctors tell me that insulin is absorbed more rapidly with these conditions. Again, discuss with your doctor beforehand, but generally speaking, the ROI Elite Coaches team agrees that a temp basal rate or less Lantus the night before helps them avoid low BGs on the slopes.