Hypos at work

[Lva1989]

I was diagnosed type 1 in March after feeling run down and lots of diabetic signs such as extreme first, urine infections etc. Due to lots of autoimmune problems HAD test was done with was positive and antibodies through the roof.

I am on 6 units morning and 4 units evening of Levimer and 1unit/15g carbs novorapid.

However I work in A&E doing 12.5 hour shifts and it has been pretty busy recently and was finding I hadn't needed to use novarapid at all with meals and am constantly going low 4 and under throughout the day on bolus alone.

When not at work if I don't use novorapid my numbers would end up in the double figures like 15.

My DN Said I could just be really sensitive to exercise and as I'm on my feet all day and barley stop not to use novarapid on work days. But do I not bolus that morning aswell? I know I'm probs still honeymooning but finding it so hard at.work.to.constantly check sugars and constantly munching glucose tabs

Anyone else had similar at work?

Thanks Leanne

 

[Jaylee]

Hi Leanne,

Yep, though I've been T1 headbutting 45 years.
I work in landscaping. Pretty active job & need to tweak my basal down, especially when it's hot?
One can become more insulin sensitive.
I find the lows can recur if I just hit it with fast acting sugar.. I normally nudge up with something sweet then follow it with something longer acting..

Do you wear a sensor or CGM set up?

 

[chrisbug]

Hi Leanne,
I treat my low blood sugars with jelly babies, then use a longer acting carb to sustain, normally a digestive biscuit works for me.
It is really hard when you work in a job that can have unpredictable bursts of activity.

Together with a hot day, it makes for challenging times

I just make sure I have all the fast and long acting carbs at the ready, and all of my work colleagues are aware.

I don't really want to bring this to my employer, as this is the very essence of my job, reacting to unforseen events.

I am very fortunate to now have a Libre 1, and have alarms set via miao miao and xDrip. This alerts me in plenty of time that I need to be making adjustments or treating an impending low blood sugar.
When my colleagues see me popping some jelly babies and having something a bit more long acting, they think I'm having a hypo, when in truth my blood sugar is at 4. 4 mmol/L and I'm just "keeping the wolf at bay".

Oh, I now have a Tupperware box that says "hypo treatment" on. People are less likely to help themselves to your stash if they know what it's for!

Take care

 

[Lva1989]

My DN said they will not give libre until 6 months after diagnoses and I can't afford to fund myself. I do think this will help as checking sugars all the time is hard at work! My colleagues know and I've been taken off nightshifts to better control but just shocked at how quick after eating carbs I am going low!

 

[NicoleC1971]

My DN said they will not give libre until 6 months after diagnoses and I can't afford to fund myself. I do think this will help as checking sugars all the time is hard at work! My colleagues know and I've been taken off nightshifts to better control but just shocked at how quick after eating carbs I am going low!

Sounds as if you are in honeymoon phase so maybe still making a little insulin.
Have an active job too and am now a pump which allows for a little more flexibility for days when I am active (reduce basal dose for the duration of the shift).
As you're unlikely to get offered a pump just yet perhaps a little basal dose reduction is in order? Also I was always told to eat some slow burn carb along with the jelly baby because you obviously have a little too much basal insulin which in combination with muscles being used (walking around and climbing stairs will do it) is enough to take the glucose down low enough to take you into hypo. Then you're chasing your tail and having to neck sweets to get it back up with all the anxiety this entails plus trying to test it with finger sticks at work in a busy environment.
If you don't want to have to keep taking hypo top ups during a shift I think you'll need to either reduce the levermir or try splitting it so that you perhaps have a little less going in before a shift ?

 

[In Response]

You could apply to get a free trial Libre 2.
Go to the Freestyle Libre website and apply online.
You will need a phone.

 

[Jaylee]

My DN said they will not give libre until 6 months after diagnoses and I can't afford to fund myself. I do think this will help as checking sugars all the time is hard at work! My colleagues know and I've been taken off nightshifts to better control but just shocked at how quick after eating carbs I am going low!

Try asking your endo? Forget the DN. There is a criteria for Libre funding. However.

Try putting it forward that, "blood letting in your work environment is inappropriate?" (of course it still is advisable to carry your meter as a backup.)
It worked for me.. But i was working on a chicken ranch at the time handling eggs & up to my elbows in carcasses & all manner of bird nasties ..

 

[searley]

I was diagnosed type 1 in March after feeling run down and lots of diabetic signs such as extreme first, urine infections etc. Due to lots of autoimmune problems HAD test was done with was positive and antibodies through the roof.

I am on 6 units morning and 4 units evening of Levimer and 1unit/15g carbs novorapid.

However I work in A&E doing 12.5 hour shifts and it has been pretty busy recently and was finding I hadn't needed to use novarapid at all with meals and am constantly going low 4 and under throughout the day on bolus alone.

When not at work if I don't use novorapid my numbers would end up in the double figures like 15.

My DN Said I could just be really sensitive to exercise and as I'm on my feet all day and barley stop not to use novarapid on work days. But do I not bolus that morning aswell? I know I'm probs still honeymooning but finding it so hard at.work.to.constantly check sugars and constantly munching glucose tabs

Anyone else had similar at work?

Thanks Leanne

I struggled for years.. my at work and at home basals are quite different for a long time I took slightly lower basals and no bolus when at work.. but then find I’m high when not at work often taking small correction doses. I never found a ‘perfect’ solution

 

[Circuspony]

Firstly its worth checking your background insulin isn't too high. If you are constantly dropping low at work even without Novorapid then it probably is too much levimer.

I have a very active morning and start with just 1 unit of novorapid for my cereal based breakfast and I also carry a pretty high sugar cereal bar with me to have an hour or so after I've started working with the horses. I know its exercise related because the minute I sit down at the laptop mid morning then my sugars go up and I need a big shot of novorapid.

But tbh in your job I'd push for the libre on the basis that you can't exactly stop for the munchies in the middle of an emergency so having that advance warning your sugars are going down is pretty critical

 

[Lva1989]

Thank you all I am hoping I can get a libre based on my job and not being able to test sugars a lot of dealing with a busy department of very sick patients.

This may sound silly but I have never spoken to an endo? Is this something I should push for

 

[LWA]

Obviously movement = exercise and when you are continually active it can be very difficult to correct levels whilst still on the go regardless of what you eat. If I’m particularly active and I go low it does help to stop a while (10-15 mins) and allow levels to raise before back to work. I find raisins great for a quick release boost (and more nutritional than glucose tabs) & Soreen (malt loaf) excellent for slow release.
Just like to add big respect to you for all the hard work you do at the hospital

 

[Lva1989]

Obviously movement = exercise and when you are continually active it can be very difficult to correct levels whilst still on the go regardless of what you eat. If I’m particularly active and I go low it does help to stop a while (10-15 mins) and allow levels to raise before back to work. I find raisins great for a quick release boost (and more nutritional than glucose tabs) & Soreen (malt loaf) excellent for slow release.
Just like to add big respect to you for all the hard work you do at the hospital

Thank you so much I hate raisins but like.other dried fruit so may try

Glucose tabs make me feel a bit sick so need to try different approaches

 

[becca59]

Thank you all I am hoping I can get a libre based on my job and not being able to test sugars a lot of dealing with a busy department of very sick patients.

This may sound silly but I have never spoken to an endo? Is this something I should push for

Yes all type 1s should have access to see a specialist. DNs are very good but to get the latest tech you need that consultant to push for it. There are many areas now supplying Libres on immediate diagnosis. So in view of your job, do not be put off pushing for one. There is no medical reason why you shouldn’t wear one, just an areas rules on holding onto the purse strings.

 

[Gemma2]

Thank you so much I hate raisins but like.other dried fruit so may try

Glucose tabs make me feel a bit sick so need to try different approaches

 

[Herbie1972]

I had hypos all the time after I was first diagnosed, because of the honeymoon period, and they did eventually become less frequent. That's 48 years ago now!

These days I always carry Dextrose tablets on me and have Jelly Babies in my work bag.

But have you talked to your DSN about going on a pump? When you're extra busy you can reduce your basal or even stop it completely, reducing the chances of hypos. Good luck!

 

[Lva1989]

Thank you for your responses I will push for the libre as I defo think it will benefit me!
First hba1c back today at 53 so I’m happy with that

 

[NewT1Kn]

Thank you all I am hoping I can get a libre based on my job and not being able to test sugars a lot of dealing with a busy department of very sick patients.

This may sound silly but I have never spoken to an endo? Is this something I should push for

I was newly diagnosed T1 after being in hospital in April this year, I’m 54. My levels are all over the place, I find it so stressful but since getting a CGM it’s not so bad. I work in the community in palliative care and was having to test a lot. I met the criteria for CGM as it’s not hygienic to test when you can’t wash hands first. You should be entitled under this criteria too. I would push to see an endocrinologist, I’m surprised you haven’t been referred to one already.
You are doing so well to be doing the job you are doing and dealing with this diagnosis.

 

[bmtest]

I was diagnosed type 1 in March after feeling run down and lots of diabetic signs such as extreme first, urine infections etc. Due to lots of autoimmune problems HAD test was done with was positive and antibodies through the roof.

I am on 6 units morning and 4 units evening of Levimer and 1unit/15g carbs novorapid.

However I work in A&E doing 12.5 hour shifts and it has been pretty busy recently and was finding I hadn't needed to use novarapid at all with meals and am constantly going low 4 and under throughout the day on bolus alone.

When not at work if I don't use novorapid my numbers would end up in the double figures like 15.

My DN Said I could just be really sensitive to exercise and as I'm on my feet all day and barley stop not to use novarapid on work days. But do I not bolus that morning aswell? I know I'm probs still honeymooning but finding it so hard at.work.to.constantly check sugars and constantly munching glucose tabs

Anyone else had similar at work?

Thanks Leanne

 

[bmtest]

Hypos at work or low blood sugars do happen especially in early days.

I have 40+ years in demanding roles I have never met a role that has beaten me.

Some roles are not fixed and can be variable each day and when you mix a variable workload with variable blood sugars,carb intake and dose its challenging.

Know the environment you work within pre empt the situation as best you can and be prepared.

With experience you will get better throwing food down your neck is something we have to do from time to time at work to save face.

But I never met anyone yet as fast or efficient at work than me diabetes or not.

I use to do the same inject a slow acting insulin Monotard whilst working with no fast acting pre pen days and walked 3 mile to work just to ensure I kick stated the day at right blood sugar.

 

[Lva1989]

I was newly diagnosed T1 after being in hospital in April this year, I’m 54. My levels are all over the place, I find it so stressful but since getting a CGM it’s not so bad. I work in the community in palliative care and was having to test a lot. I met the criteria for CGM as it’s not hygienic to test when you can’t wash hands first. You should be entitled under this criteria too. I would push to see an endocrinologist, I’m surprised you haven’t been referred to one already.
You are doing so well to be doing the job you are doing and dealing with this diagnosis.

Thank you, I got told that also due to infection control of finger pricking non stop it’s obviously not hygienic and good to have ‘open wounds’ and I can’t obviously plaster all my fingers haha

I’m gonna really push for it, I saw my go today for a meds review and she said she’s gonna chase it as I should be having more appointments as it’s early days!

Work is full on but I love it so much so defo keeps me going! Amazing what you do in palliative care, gotta be a tough cookie, hats off to you!