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Back to work and the problems start again.

C

Clarky

Member
Messages
20
I struggle with hypos at work. I do a very physical job. I've gone down to as little as 4 Levimir on work days and don't need to take any fast acting insulin with breakfast, or my two work meals. I only use Nova Rapid with my evening meal.

That's basically my situation. I have to snack between meals to avoid hypos while I'm at work. Sometimes this works, sometimes I go slightly low. I eat set meals at work, so I guess sometimes I work harder, causing the hypos. I'm working towards reducing my hypos, by eating more and changing the times I eat, I'm getting there slowly.

That's not my problem today, this is... Today was my first day back at work after Xmas. Over the Xmas period I've slowly increased my Levimir to 9 units at night and 8 in the morning. I was also on a Nova Rapid ratio of 1 unit to ten carbs. This worked fairly well. I was eating three times a day at set times, my BG was where it should be after 2-3hrs and if needed I could vary the times I ate without too much problem. All in all I was happier than I'd been with my diabetes since being diagnosed last June.....

But then I went back to work today. So last night I reduced my Levimir back to the 4 units before bed and didn't take any Nova Rapid with my breakfast. But I couldn't sart work today because of the cold weather (I'm a bricklayer). So I came home and took 8 units of Levimir. Which is what I would have taken if it were still the Xmas holidays. I had my mid morning meal at normal time and took the normal amount of NR as if it were a normal non work day. An hour later my BG crashed to 2.9! I corrected with Dextrose and a cup of tea and relaxed for a bit. I had my lunch a bit later and thought I wont bother with NR and see what happens. Again, crashed after about 2hrs, but caught it at 3.5.

What's going on?? Surely with less Levimir on board, my BG should be going up, not crashing with a vengeance! Am I doing it wrong decreasing my Levimir so much for work days??

Any help would be much appreciated. Thanks for reading.
 
What you are doing sounds sensible. It sounds like you need to cut your levemir dose even a bit more on work days. Novonordisk do a half unit "demi" and "junior" pen. Okay, they have coloured balloons on them but so what?

I do wonder if you would be a good candidate for an insulin pump? This gives you much finer control over your basal rates. These are hard to obtain on the NHS and the needle placements could be awkward since you are so active. The way to find out is to ask your consultant.
 
The half pen sound great. Will speak to my Doc about it.

I've thought about the pump and love the sound if it, but they seem a bit bulky from what I've seen. I think it would be better for me though.

I just don't understand why after dropping my Levimir, I've been crashing so much today.
 
The problem with Levimer or any background insulin it doesn't lend its sef to adjusting on a daily bases, and can hang around in the system so a general rule of thumb, is when you make any adjustments wait a couple of days to see the reaction to the adjust ment..

This will make it difficult for you..

I wonder if actually using an insulin pump might be more effective in your control, as you can alter the basal rates for work day and rest days, and if a work day becomes more active you can lower the rate of basal insulin even turn the thing off, which I have been know to do with my pump when working..

Another method might be worth considering and I'm not sure how this will pan out, is instead of dropping your quick acting, not injecting the levimer and using the quick acting to keep your blood glucose in check through the day!

But I would defo have a word with your diaebtic clinic about the pump though, as it sounds as work wise you could be a very good candidate for benefitting from one
 
I've wondered about dropping my Levimir and just using Nova Rapid for meals, but have been told I need some slow acting stuff in my system at all times........

I'm going to speak to my nurse about my situation tomorrow, because everything seems to point to a pump. I'm not sure I want one, but on the other hand I just want to get on with my life.
 
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