Do you bolus when you are at work? | Hypos at work | Lunch at work

HomerSimpson said:

I need your opinion. Do you bolus at work for lunchtime? If so, how much rapid insulin do you give yourself? Also, how many times a month do you have hypos at work?

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If I didn't bolus at work I couldn't have lunch (unless it was no carbs) - which would just not work for me and everyone would know about it, I'd be starving, it would also mean I couldn't correct. Eating carbs and not bolusing is not an option

At once point I was having lots of hypos at work because I wasn't really taking care, last 10 years never needed any help at all, have gone low but recognised and treated (not going low at all can be really tricky unless you are high a lot of the time)

HomerSimpson said:

Can I just eat a low carb lunch, so that I won’t need any insulin?

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The short answer is, try it out and see what happens. Not bousing would not work for many. But for someone who is recently diagnosed and still making lots of insulin, just eating a low-carb lunch may work. Having said hat, testing basal action to see how background insulin needs are covered would in any case be a good idea. The idea is that basal insulin should keep blood glucose stable in the absence of food. Exercise complicates the assessment. So getting some exercise everyday, including weekends, helps maintain insulin sensitivity at a stable level.

HomerSimpson said:

But do you reduce your insulin when bolusing? Working in nursing homes is such an active job. I would go hypo all the time if I didn’t reduce my insulin.

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I don't because I do an office job so am sitting down all day, as @EllieM says it depends on you, you will need to do trial and error to work out how much it'll need to be reduced by because its an active job.

When having a very active day (be it at work or something else) I need a lot less insulin.
Testing frequently is the only way to find out what works best for you!

@HomerSimpson unfortunately, as we are all different and do different jobs and have different lifestyles, much of or diabetes management tends to involve a bit of trial and error to find out what works for us.
Like others my job is desk based but when not at my desk working, I am very active so understand your quandary. When I do something like go for a day hike with a lunch/picnic in the middle, I will still take my bolus with my meal but will take less than normal. If my ratio was 1 unit of insulin to 10g carbs, I would change it to 1 unit of insulin to 15g carbs (which is the same as taking 2/3 of the amount of insulin I would normally take for that meal). This works for me and may be a starting point for you but you are likely to need to tweak it. If you are concerned about having a hypo at work, you could start more conservative (e.g take half as much insulin as you would normally take).

Test regularly to see what impact the insulin and food has had and keep hypo treatment with you at all times (you should not need to get back to a staff room when you have a hypo.)

Remember, not every day is equal. You may be more active one day and less the next; you may be stressed one day and partying the next; you my have a sniffle one day and be drinking over night the next; ... If activity effects your blood sugars, you will see differences in your readings. For this reason, unless your blood sugars go very high or your hypo, I would trial a dose for a few days before tweaking.

HomerSimpson said:

But do you reduce your insulin when bolusing? Working in nursing homes is such an active job. I would go hypo all the time if I didn’t reduce my insulin.


For the sake of argument, let’s say a meal (after carb counting) is worth 12 units of rapid insulin. Do I only give myself 6 units to avoid a hypo in an active job?

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Hi there, my job is extremely active, on shifts and goes from sitting at a desk to being in the middle of a riot in minutes!!!! At work I ALWAYS adjust my novarapid accordingly. I eat my meal and bolus for it and yes, I may give myself a unit less to account for being at work and knowing my glucose levels fall far faster at work than when they do if I'm watching telly. If I get 'caught out' and still end up going too low then I take emergency carbs to deal with it. I think that it is good to find yourself a strategy that works for your lifestyle/work BUT be prepared for those times when it goes a bit wrong. There is nothing wrong with reducing your insulin for meals, it's not a 'medicine' as such in that you MUST take a set amount, it's a hormone, you take enough to keep your levels in range. For example, if my meal at work is quite low carb I don't take ANY insulin for it. You will know if taking your 6 units instead of 12 works ONLY by testing. x

HomerSimpson said:

Hello all

I am a recently diagnosed T1D on multiple daily injections of Humalog and Tresiba.

When I am at home doing nothing, I bolus for lunchtime and teatime, which is usually 14 units of Humalog.

If I am going to town to pickup prescriptions, I plan ahead and make sure Tresiba is my only insulin onboard. It is a 22 minute return trip by foot, and, by the time I return home, I am usually still in the target range without significant hypos.

Concerning having an active job, I would like to know if you eat lunch and thus bolus at work.

I used to work in nursing homes, in which I did 12 hour shifts and hardly had time to sit down. It involved a lot of standing up and running to different rooms and floors.

I left that job just before I was diagnosed to avoid the coronavirus outbreaks, but am now thinking of going back.

I need your opinion. Do you bolus at work for lunchtime? If so, how much rapid insulin do you give yourself? Also, how many times a month do you have hypos at work?

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Should I just skip lunch and just eat when I get home?

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Hello,

I'll hazard a guess that if you are recently diagnosed, you could be honeymooning with the pancreas chiming in a little before it finaly packs up? So, till things settle. It may feel a little like "rolerskating on an ice rink" at times...

OK, work & insulin. (I've had some "tail chasing jobs in my time, this is how I handle it.) Firstly make sure your basal is on an even keel.
I notice you use a Libre if you can see a way to using a Bluetooth bridge with it? You will find this helpful.
(But keep your BG meter to hand also.)
If you have a set break pattern & know the carb content of your "lunch," a crafty pre bolus (rule of thumb 20 minutes.)
Before down tools for break. Nothing worse than juggling the meter, pen & lunchbox at the same time.

I appreciate you work in care. My background is (was) engineering production. I've also had a fair bit of experience in warehouse work. (Lol, attempting to atribute some of the posisitions I've had with your noble proffession. I've done some "odd jobs" in my time including a kid's entertainer at a Southwest holiday camp.)
One piece of workware that comes in handy. Those builder's trousers? Or "cargo" trousers.
I can carry my pen, meter & potential hypo treatment with proffessional flair.
Hope this helps with your choice regarding return to work.

Best wishes.

HomerSimpson said:

But do you reduce your insulin when bolusing? Working in nursing homes is such an active job. I would go hypo all the time if I didn’t reduce my insulin.


For the sake of argument, let’s say a meal (after carb counting) is worth 12 units of rapid insulin. Do I only give myself 6 units to avoid a hypo in an active job?

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Generally your insulin dose wouldn’t decrease that significantly unless you were running a marathon right after lunch.

It’s generally more like a 10-20% decrease in dose if you’re active but maybe even around 30% decrease if very active.

The diabetic nurse at my GP recommends around a 20% decrease but obviously everyone’s body is different

talk to your diabetic team about getting a CGM(continuous glucose monitor),e.g. Dexcom 6,Medtronic guardian 3, or freestyle libre, as they will record your blood sugar's around every 5 min's and show how your body is reacting to food, lifestyle and insulin. the first 2 will alarm when going high or low