Planning Energy Needs and Insulin Pump Functionality in Cold Environments

At the end of January, I will embark on a top ski touring course in Norway. As a person with diabetes using a Tandem t:slim X2 insulin pump, I have carefully considered how to manage my diabetes in the extreme conditions ahead. From adjusting insulin doses to ensuring the pump has sufficient power, I aim to share my experiences and strategies for tackling this unique challenge.

Considerations for a Top Tourski Tour in Norway Embarking on a top tourski tour in Norway's challenging winter environment requires careful consideration, especially since this is my first time navigating such extreme conditions with an insulin pump.

Here are the areas I have focused on in my preparations:
Insulin Adjustment: I have been in close dialogue with my diabetes nurse and doctor to ensure I am well-informed about how cold temperatures and sustained physical activity may impact my body and alter my insulin needs.

Infusion Set and Temperature Control:
It is crucial for me to ensure that my infusion set functions correctly in extreme conditions.

Reliable Charging Solutions:
My Tandem t:slim X2 pump requires USB charging, so I have prioritized ensuring a stable power source.

 

Managing My Tandem Insulin Pump in the Cold
My Tandem t:slim X2 insulin pump is equipped with a rechargeable lithium-polymer battery, which can typically last up to seven days under normal conditions. However, cold temperatures can reduce battery efficiency, and in near-freezing conditions, I anticipate a 20-30% reduction in battery life. Since I haven’t used the pump in such cold environments before, I need to be thoroughly prepared.

To ensure optimal functionality, I keep the pump close to my body in an insulated pouch.
For more insights, see my blog post about preparations for the Svalbard trip.
I am also bringing a 10,000 mAh power bank, which in theory could provide approximately 20 full charges for the pump (this estimate doesn’t account for reduced efficiency in cold temperatures). Additionally, I have a solar panel to recharge the power bank.

Carbohydrate Intake During Intense Physical Activity
For a 5-6 hour ascent where most of the effort is uphill, I expect to burn around 2970 kcal. This energy expenditure requires approximately 874 grams of carbohydrate intake.

To make this practical, I calculated that this corresponds to about 58 slices of rye bread, assuming each slice contains 15 grams of carbohydrates. Alternatively, I can supplement with energy bars, gels, or fruit to reduce weight and make it easier to eat on the move. My experience from the Svalbard trip taught me that vacuum-packed rye bread can freeze solid in extreme conditions.