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managing blood glucose with an active job

G

gregg53

Member
Messages
5
I am an insulin dependant type 2 diabetic and am looking to start a very active job. How do I go about managing the expected hypoglycemia?
 
Mileana said:
What sort of insulin are you on?

Long-acting only, biphase/premix or basal/bolus?
Click to expand...


I live in the United States. The kind of insulin I take is Novlin 70/30. It is a mixture of long acting and fast acting insulin.
 
Okay - so you have insulin in the morning which is expected to cover breakfast and lunch, and a dose later which is meant to take care of dinner and a snack, I am guessing.

That can be a real tough one to get right - I was on it myself before going onto basal/bolus (long acting and short acting done inddividually).

Do you have a good idea how many carbohydrates you need to stay on your blood glucose target at the moment for each meal, or is it already tricky for you?

I think the easiest way if you are okay with a few more injections would really be basal/bolus - inject long acting insulin once of twice a day, then for each meal take short acting - lets you be more flexible and reduce dose depending on the meal and your activity level - it made the world of a difference to me at least.

Is that an option for you, or would you have to figure it out with this insulin, I wonder?

-M
 


Yes, I have a good idea on how to manage by carb intake in my present situation. I would like to get some information on how to manage an active job with my current dose of Novlin 70/30. I will consider using basal/bolus.
 
What I experienced with the Novolin/NovoMix is that it tends to send you into hypo at an unpredictable time. If you increase your exercise/activity level, you should add more carbohydrate or lower the dosage of insulin.

Can you do something similar to what your job will demand of you? Dig the garden if you have one? Walk around as much for a day as you expect to have to in your job?

What you need to find out is where exactly your insulin peak effect is, and then eat some carbohydrate around this time to avoid going low - but to do that in the right amount, you need to have a fairly good idea about how much your new activity will drop your blood glucose over the day - for me, I always knock off about 2 mmol/l if I have them spare for the first hour of walking, then I can expect to drop about 1 mmol/l per hour - just for walking at a steady pace. I have done 6 hour walks and walk a couple hours each day. To deal with this on my very flat insulin profile (basal only on those days when I walk far), I have to have 5g of carbohydrate per hour.

For most people, 10g of carbohydrate will make their blood glucose go up by 2-3 mmol. If you expect what you do to drop you that much, then you should have 10g of carbohydrate to match this.

I have some protein bars with me normally - nicely wrapped up, I have a half one of those every 45-60 minutes when walking. I also often have a bag of mixed raisins and nuts with me - I eat a handful of nuts now and then, that seems to curb the tendency to go low on my short walks - and if I start feeling or testing myself to be low, I have a few raisins.

If you do go hypo, jelly babies are used by many, glucotabs can be used too.

On basal/bolus when I plan a long walk, I reduce my long acting insulin by 25 percent the morning before - same in the evening - my insulin sensivity will go up and I need a bit more margin too, and also on the actual day. I then in the morning take about half the rapid acting dose I normally would - I can't do without it, as in the morning, my muscles don't understand how to use sugar otherwise. Then around lunchtime, if my blood sugar is low or on target, I don't have any insulin - my remaning own insulin will work alright, and the presence of my basal insulin will be enough. On the night following a day like that, I keep my basal down at the 75 percent level, but may or may not inject a rapid-acting insulin with dinner, again about half the dose. But that's just me. I do find it much much easier to manage this way, though as I can aim more precisely and I know exactly when to expect what result from my insulin.
 


I guess my first task is to find out what my blood glucose does with the amount of exercise I am facing. I am aware somewhat of the behavior of my blood sugar when I walk for an hour. Thank you for this advice. One more question at present: what is mmol? In the United States, I think we measure blood glucose by mg/dL, which may stand for milligrams per deca-liter? :?:

-G :thumbup:
 
http://www.diabetes.co.uk/blood-sugar-converter.html

mmol/l is the European standard for measuring blood glucose - it converts 1 mmol/l to 18 mg/dL

So to replace the values in my previous post

I drop 18 mg/dL for every hour of light/moderate exercise but can be 36 mg/dL for the first hour if my starting point is a bit high
....
10g of carbohydrate normally raises someones blood glucose by about 36-54 mg/dL
...
etc.

For smaller amounts of blood glucose (up to about 60), I would take the liberty of converting 1 mmol to 20 mg/dL - multiply by 2 and add a zero - if you're talking about more than that, you need to be careful as it would get too inaccurate by using 20 instead of 18.
 
Thank you for the information. Your in-depth knowledge of how your blood sugars work during exercise have encouraged me to find my own.
 
Glad to be of assistance. We're all different, and the only thing that can be said for sure, I think, is that the more you test and pay attention the easier a time you will have figuring out what works for you.

I wish you the best of luck with the new job and the insulin as well.
 
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