In the Tandem Control IQ the Temp Basal does run with the algorithm running and can be set for a duration of time. No need to switch profiles. I have found it very useful with the lates update to CIQ, it was not available previously.
Thank you for the study link.
1 Like
Hey @richard!
Glad to hear youāve figured out your morning exercise - thatās a lot to celebrate right there 
I will say, personally, spontaneous activity is one of the greatest challenges in managing T1D (in my opinion). So I wish I had a quick fix or solution, but elevated IOB is simply challenging with T1D because we cannot get the insulin out of the circulation fast enough!!!
That being said, I could go on about this all day (yes, we need even faster insulins), but I wonāt One of the main strategies with elevated IOB is to consider larger, and more frequent carb snacking - since you simply donāt have as many options when it comes to settings that you can adjust on the fly (that will work now, when you need them to). Itās still important to set Exercise mode when you remember, but note that it may not effectively reduce the risk of hypoglycemia until the middle or end of your hike when IOB has decreased.
I know this doesnāt always work, but a few things I always tell kids that I work with (kids are very spontaneous, so I deal with this type of question a lot!), try to move your activity if you can. Simply delaying the activity by 1-2 hours will effectively lower IOB and in that time, you should have Exercise mode on to help you when you are ready to start. Of course, this is not reality thoughā¦and in those cases, I also suggest for hikes, carrying a bottle of 1/2 Gatorade and 1/2 water so itās not TOO much carb, but enough to sip on as you start an activity with higher IOB.
My go-to when I have high IOB and am starting a hike - I choose my favourite gummies or gel and this larger carb snack at the start will help offset the high IOB.
Hope this helps
1 Like
Thanks Dessi! Thatās super helpful. One follow up question: whatās your favorite benefit of exercise for people with T1D? Is there a type of exercise you recommend the most for those benefits?
1 Like
Hey @LaurenF,
Thanks for your questions!
I will say, the position statement took over 1.5 years to put together with my colleague Dr. Othmar Moser along with 25 other leading experts in the field of exercise and T1D. This was quite the undertaking, but I think we came up with some really lovely figures. In the position statement, each commercially-available AID system (at the time of publication) has a standalone figure (it is a wheel or circle figure) that discusses strategies with each specific system around 1) planned exercise, 2) unplanned/spontaneous exercise, and 3) different types/intensities of exercise. Weāre really proud of these figures because many people donāt want to read a 30 page PDF, but the figures serve as a nice summary of ātips and tricksā. I encourage everyone to check it out online!!
What Iām looking forward to with the next position statement? Well, Iām currently leading the ISPAD exercise consensus guidelines for 2026 and Iām excited to hopefully create a more patient-friendly document that has nice figures because we have learned from past documents - theyāre LONG and (sorry) dense. We hope more people will find the pictures, illustrations, and figures helpful! Iām also really excited for the advancements in AID technology. Just from January 2025 to now, there are already more pumps on the market, more algorithms being developed, new advancements to CGM, etc. and this gets me very excited!!!
A great app that was developed by a colleague and friend of mine Sam Scott - itās called Enhance-d and their app does a great job overlaying activity data and CGM. People should check it out online and on the app store. Weāre also working on this at Stanford in a clinical context to help providers see CGM and activity data together Lots on the horizon!
1 Like
Thanks!
Yes, spontaneity is not easy and there are a myriad of factors at play. Iām in Sleep Mode 24/7 and I know that āover basalizationā can also play a part. Diabetes management would be so much easier if we didnāt need to deal with eating or exercise!!
I have a number of different profiles set up on my Tandem and a temp bolus or even turning off all insulin with a 30 minute alarm can help. Looking forward to dual-hormonal pumps when glucagon can be put to work to help balance things out in exerciseā¦..
Thanks!
2 Likes
@insulindsay Great question!
The number 1 benefit for me is my HAPPINESS post-exercise. Exercise and movement can do so much for our overall well-being and mental health. The second benefit Iāll mention for diabetes specifically is the increase in insulin sensitivity for up to 24-48 hours post-exercise!!!
I always like to say that ALL MOVEMENT IS GOOD MOVEMENT!!! Depending on what your goals are (build muscle, lose weight, performance), then different activities may be beneficial for different people. Itās always good to get a combination of aerobic and resistance exercise for overall health benefits (cardiovascular health and also strength). We need to move our bodies more and we need to encourage physical activity and exercise for everyone. Many people do not meet exercise guidelines (for adults, at least 30 mins per day of moderate to vigorous physical activity and for youth, at least 60 minutes per day most days of the week).
Find activities that you enjoy because that will help you stick to it and want to go back If you donāt enjoy weightlifting, try an aerobics or pilates class. If you donāt like running (like me), try rock climbing or weight lifting. I always say that group classes a good way to help you stay accountable!
1 Like
Thank you everyone for joining the session today! I hope your questions were answered and you learned something new
I always have fun connecting with the community - letās try and get some movement in today!!
Have a great day and remember that weāre always here on DiabetesWISER to chat and connect with you all if you have exercise-related questions.
Best,
Dessi
1 Like