How Diabetes Camps Are Using Smart Insulin Pumps and Meal Adjustments to Keep Kids Safe During Activity

Keeping blood sugar stable during sustained physical activity has long been one of the trickier parts of managing type 1 diabetes in children. A diabetes camp—where kids are active most of the day for several days in a row—is an ideal real-world setting to test strategies that work. Researchers from the Diabetic Medicine journal recently analyzed data from two 7-day camps involving 77 children aged 8 to 14 to see how well a specific protocol could keep them safe and in range.

The study looked at children using three different modern automated insulin delivery (AID) systems: the Medtronic 780G, the Tandem Control-IQ, and the CamAPS pump. All three systems have built-in exercise modes, and the camps activated these modes throughout each week. In addition, the research team used an adaptive algorithm—essentially a smart set of guidelines—to reduce the amount of insulin children received with their meals based on the level of activity and how their bodies were responding.

The results were encouraging. During the camps, children spent a median of 80% of their time with blood sugar in the target range. Low blood sugar time was minimal: just 3% at mild lows (level 1) and 1% at more serious lows (level 2). Importantly, there were no cases of severe hypoglycemia requiring outside help, and no episodes of diabetic ketoacidosis, a serious high-blood-sugar complication.

On average, the adaptive algorithm reduced meal insulin doses by about 45% compared to what the usual calculation would have been. However, this varied widely—some children needed reductions of only 10%, while others benefited from cuts as high as 110%. This variation underscores that every child's response to exercise is different.

Interestingly, the children's glucose control actually improved during camp compared to their readings from the 14 days before camp. Time in range went from 78% to 80%, and time below range stayed low. The results were similar no matter which of the three pump systems a child was using, suggesting the protocol is robust across different technologies.

This study demonstrates that with the right combination of tools—modern automated insulin delivery systems, exercise modes built into those systems, and a thoughtful plan for adjusting meal-time insulin—children with type 1 diabetes can participate fully in weeks of physical activity while maintaining stable blood sugar and staying safe.

The adaptive meal-bolus reduction algorithm is not something families would apply on their own at home; instead, it represents the kind of structured, data-informed approach that diabetes camp staff and healthcare teams can use to support children during high-activity periods. The fact that it worked similarly well across three different pump systems suggests this is a practical framework that could be adapted and applied in various settings where children are active for sustained periods.

Source: Diabetic medicine : a journal of the British Diabetic Association. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.