Is prevention better than cure?

[mattmo86]

Hi guys.

So I was at diabetes clinic yesterday. Doc wasn't impressed with my bloods or attitude. Anyway we had a rather heated discussion over hypos and lucozade. I work nights, doing physical work, lifting stuff, moving cages, unloading lorries that kinda stuff.

If my blood is say 8 around 11pm, bearing in mind my meal wont be till 0130-0200, I would have lucozade as I know from experience, I would be hypo before lunch time. Apparently Im not to have lucozade until blood is below 4.

My question is, is it not better to prevent the hypo, than waiting for the hypo before you do anything. Yes I understand that my blood does go quite high once ive had the lucozade, so I will agree I could drink less, but they wouldn't even have that. I know highs are bad, but it seems hypos don't matter until its actually low.

Thoughts?

 

[donnellysdogs]

It appears that neither you or your consultant are addressing the real issue... How to get you to stay between 5-8 on nights when you work...

Can you give more info regards the type of insulin regime you are on, the qty of carbs that you eat, and qty of insulin units?

You ate having too much insulin or not enough food or are too scared to drop to normal levels for fear of hypo's.

The aim for both you and your consultant to get you in a work situation with levels that are even and under 8.

I personally would never have any hypo stoppers at a level of 11... That is way out of control.

 

[iHs]

Hi guys.

So I was at diabetes clinic yesterday. Doc wasn't impressed with my bloods or attitude. Anyway we had a rather heated discussion over hypos and lucozade. I work nights, doing physical work, lifting stuff, moving cages, unloading lorries that kinda stuff.

If my blood is say 8 around 11pm, bearing in mind my meal wont be till 0130-0200, I would have lucozade as I know from experience, I would be hypo before lunch time. Apparently Im not to have lucozade until blood is below 4.

My question is, is it not better to prevent the hypo, than waiting for the hypo before you do anything. Yes I understand that my blood does go quite high once ive had the lucozade, so I will agree I could drink less, but they wouldn't even have that. I know highs are bad, but it seems hypos don't matter until its actually low.

Thoughts?

Prevention is definately better than cure where hypos are concerned. If your bg level is on 8mmol at 11pm when you start work and you know from experience that by your next meal you will be hypo by 1.30-2.00am if you dont eat anything, then by all means eat something carby to last you the 3hrs if you are doing strenuous work which will lower your bg anyway.

 

[mattmo86]

Am on 24 units of lantus at 8pm, and novorapid, which I change, but that is guess work as opposed to carb counting. last time I did carb counting was in my teens, im 26 now. I eat quite a lot of high carb stuff pasta, pizza etc and a lot of sugary stuff.

I like my blood to be high as I am scared of the hypos, and again would rather it be higher and not have hypos.

The doc I seen yesterday had some language issues with me not understanding her and her not understanding me, again she was what I call a text book doc, one who relies on that and cant accept anything else other than what shes read.

 

[Thundercat]

I agree completely with donnellysdogs. You have a very pppr grip on yoir diabetes control and, while I know it is a lot of effort, if you can get your insulin/carb ratio sorted you could avoid the pre meal hypo. I hate hate hate hypos but taking lucozade at 8 iss asking for trouble down the road. Please try carb counting again. Since starting it and reducing my carbs I have far fewer hypos and those I do have are much easier and faster to treat.

Sent from the Diabetes Forum App

 

[SamJB]

Hi matt,
I too had s fear of hypos and used to run my levels high. We all know that lucozade will cause you an immediate high. Maybe it's better to have something that's slower releasing like a sandwich or cereal bar. I know hypos are horrible, but we're all aware of the long term dangers of high levels.

 

[donnellysdogs]

You know highs are bad, you know hypo's are too.. So why can't you try to stay on an even keel?

Long term the swings in your blood levels and being in the higher limits are mire likely to cause you problems with your eyes....

What is stopping you trying to stay at a normal level?

 

[AMBrennan]

Apparently Im not to have lucozade until blood is below 4.

Well, you are both wrong. High BG damages blood vessels and leads to all diabetic complication, so pushing BG sky-high at the start of the shift is not a good solution to your work causing Bg to fall - it would be much better to consume food at a rate to balance the effect of physical activity; that could be a slower-acting carbohydrate snack or having a bottle of Lucozade *over the course of a shift*

Comments about not getting meal-time insulin wrong are a red herring - the problem is that you, unlike a healthy person, have a constant acting basal insulin rate determined by the lantus/Levemir dose taken the day before which means that you, unlike a a healthy person, cannot reduce insulin release in response to exercise or similar physical activity.

I'd suggest that you ask if A shorter acting basal insulin might be better for you (I.e. levemir if you are not already on it) where you could take a lesser dose before work and normal dose for the rest of the day and days off.

 

[noblehead]

The logical thing to do is to adjust your insulin so that you don't hypo at the same time every night, this is something that your consultant should have suggested already, if you must take a snack on board then your better eating a slow-acting carb rather than drink lucozade.