Into the water with the YpsoPump
27-year-old Luisa loves swimming and has always been a water rat. Even her diabetes diagnosis at the age of 20 couldn't stop her from continuing to swim and take part in competitions. On the contrary: her diabetes has even spurred her on to adapt her training even better to her health and to find out what she can do to achieve the best results – for herself and for her team.
How long have you been a swimmer and why is it your great passion?
I've been swimming with the DLRG since I was ten years old. At first I only took part in swimming training, but over time I took on more and more tasks in the organisation: At first, I was on guard duty at a swimming lake in the summer months, then I took on the training of our junior members and later became a member of the board. I myself really enjoy swimming and I would like to pass on this enthusiasm as a coach. In addition to fun and games, it is immensely important to me personally that the children learn to swim safely. Unfortunately, fewer and fewer children of primary school age in Germany can swim safely. That's why my greatest motivation is to do my bit to change this.
As far as my own competitions are concerned, I think it's great that we are travelling as a team. I am very ambitious and would like us to achieve a good result as a team. I don't want my diabetes to be an obstacle to this.
You were diagnosed with type 1 diabetes when you were 20. How did you deal with it?
It was a shock for me at first, of course. Especially knowing that you have a disease that will be with you for the rest of your life. Fortunately, however, I received a lot of support from my husband and my family and started to find out all I could about living with diabetes while I was still in hospital. I then set myself a clear goal: My diabetes shouldn't stop me from doing anything I enjoy. Especially not from continuing to go swimming. And then the work really began. Weighing food, calculating carbohydrates and insulin units. At that time, I started an intensified conventional insulin therapy (ICT), where you have to check your blood glucose level several times a day and have to calculate everything "on foot". A lot has changed in recent years in terms of technical aids.
How did you come to myLoop?
I did pen therapy for the first few years. A pump was out of the question for me. I had reservations about wearing something on my body and especially about swimming. However, I became increasingly interested in pumps and researched them. The size of a pump was always an important issue for me. It was only when the YpsoPump with the mylife app was offered that I decided to make the switch. I liked the fact that the YpsoPump is so small and light. In the end, the operation via smartphone was the decisive factor that convinced me. When myLoop came onto the market, my diabetes counsellor made sure that I could switch directly to the system for automated insulin dosing. I am very satisfied with myLoop.
What are the advantages of the myLoop for you?
The Loop is an incredible relief. For me, it means a much better quality of life because I don't have to calculate everything myself and my mistakes are corrected automatically. What's particularly great is that the app is so easy to use, it's all very logical and self-explanatory. Of course, it would be great if the CamAPS FX algorithm could also run on the iPhone. I hope that the approvals for this will be finalised soon.
Where do you stow the pump and smartphone when swimming?
The usual carrying systems are out of the question for me when swimming because there is too much water resistance. So I had to get creative myself and find a customised solution: I sewed the fabric pocket of the YpsoPump Clip into my own swimming costume. Swimming is a bit different from other sports, as I can't take my smartphone into the water and the connection would break from the edge of the pool. That's why I only use the YpsoPump in manual mode when swimming. I have set my own swimming basal rate for this, which corresponds to a temporary basal rate of 50% of my normal basal rate. It took a lot of trial and error before I found the right solution for me.
What do you do differently during a competition than during training?
During a normal training session of one hour, I take the pump off some time beforehand to get to the right glucose output value for me. Officially, the YpsoPump is approved for use in water for one hour, but in my experience the training works very well even with the interruption. After training, I usually end up back in the target range automatically. However, there are many factors that influence blood sugar, such as the water temperature. However, if I'm not doing so well after training, I fully trust the algorithm to bring me safely back into the target range.
In recent years, I have also taken part in 24-hour competitions. The aim is to swim as many kilometres as possible within 24 hours. Of course, you always have the option of getting out of the water and taking a break. A 24-hour competition requires meticulous preparation and I have tried out and experimented a lot to find out what suits me best and is practicable. During the breaks, I use the time to read my glucose levels and eat extra carbohydrates. The bottom line is that a competition like this requires an incredible amount of carbohydrates. In total, I need around half a kilo of cooked pasta, fruit or muesli bars. I prepare everything in advance in food storage containers, weighed out exactly so that I know how many carbohydrates a portion contains. I now have a lot of experience and know my body quite well, so I know how much I need to eat between meals.
What tips do you have for girls or boys with type 1 diabetes who are enthusiastic about swimming and dream of becoming successful athletes?
Generally speaking, every body is very individual. I would like to encourage all sports enthusiasts with diabetes to try out what works best for them personally. And the most important thing is to keep at it. It took me quite a while to find the right approach for me. I've had more than one hypoglycaemic episode along the way, and I've also had to stop training because my sugar wasn't up to it. But at some point you reach that point where you can assess your body so well that sport can be sport again and diabetes management is no longer the main focus.
What are your thoughts when you watch swimming competitions at the Olympic Games?
Of course I look up to each and every one of them and am always amazed by the top performances of the athletes there. I'm particularly cheering on our German swimmers and hope that they can win a medal or two. When I watch the competitions, I pay particular attention to the technique and try to learn something from them.
Do you know or have you heard of an Olympic athlete with diabetes 1? What do they need to consider?
There are many top athletes with type 1 diabetes - even at the Olympics. Weightlifter Matthias Steiner or hockey player Timur Oruz immediately spring to mind. I don't think there is a one-size-fits-all recipe for how to best harmonise diabetes and sport. It's important to get to know your own body and analyse how different types of training (different sports, duration, intensity) affect your blood sugar levels. Then you can make appropriate preparations, such as reducing the basal rate before, during and/or after exercise.