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Night shifts and insulin use

Discussion in 'Type 1 Diabetes' started by Frankie_m, Nov 20, 2020.

  1. Frankie_m

    Frankie_m · Member

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    I am looking for advice as I have just started night shifts at Tesco restocking shelves. The work is quite physical and shifts are 9 hours with 1 hour 30 of break which can be taken whenever.

    I am having a problem with hypos. For the last few nights I have had 2+ hypos per night due to the fact that when I inject the tiny amounts of insulin are absorbed immediately.

    Yesterday, I had 100 grams of carbs on my first break as my bloods were plummeting although I didn’t immediately jab as this would cause me to have a hypo. After going high I did 4 units (for 100 grams of carbs) and as I suspected, i almost instantly dropped low again. This has happened on multiple days this week and i cannot seem to sort it.

    I have tried dropping my lantus and have dropped it by 8 units in total. This has not seemed to help.

    I am 18 and have had diabetes for around 16 years. Any advice would be much appreciated.
     
  2. MarkMunday

    MarkMunday Type 1 · Well-Known Member

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    Have you considered changing the timing of your Lantus? As you are now working at night, you don't need as much basal insulin action during that time of the day.
     
  3. Frankie_m

    Frankie_m · Member

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    I slowly shifted my lantus timing so that I do it now at 8am when I go to sleep. Weirdly when I started my bloods were best after the lantus had ran out (as I used to do it around 12 - 1 at night).
     
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  4. MarkMunday

    MarkMunday Type 1 · Well-Known Member

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    Doing basal testing over the 24 hour cycle gives a good idea of the level of basal cover and where it may need to be adjusted. Start the test with blood glucose in the target range, skip a meal/bolus and test every hour until the next meal. If blood glucose drops much during this time, there is too much basal insulin action, And vice versa. Repeat the test on different days over different mealtimes and record the data. You will then have a good picture of what is happening and figuring out what to do about it will ne much easier. Be aware that exercise increases insulin sensitivity. So, for example, if you test on a day you are not working and you don't get a similar exercise, results may not be meaningful.
     
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  5. Jaylee

    Jaylee Type 1 · Moderator
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    Hi,

    Welcome to the forum.
    If it's any help? Oddly on the nights I was gigging basal tailing off with my Lantus, my BGs were spot on. Even hovering at 4.8mmol the latter half of the gig?
    I put it down to be a little less insulin resistant due to the activity in the evening..
    You may find 8am may work for you?

    Best wishes with your new shifts..
     
  6. Frankie_m

    Frankie_m · Member

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    Thanks, I’ll give it a go.
     
  7. Frankie_m

    Frankie_m · Member

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    Thanks for the advice however I have been injecting at 8am for the past 3 days and I have had the same problem even after lowering my lantus by 8 units.
     
  8. Jaylee

    Jaylee Type 1 · Moderator
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    Hi Frankie,

    Easier said than done. We are all individual metabolically.. But either your basal rate is still not quite right? (I or no one can advise on speciric bespoke dosage.) https://www.mysugr.com/en/blog/basal-rate-testing/

    Or what you bolus for break times with the timing is out for the carbs consumed?
    Now, I appreciate breaks can be rushed? (Test, jab, scoff meal. When the "bell" goes.) I work in engineering, have worked for Coop group. & even in a holiday camp at some point.. Among other more lapse stuff..(Yeah, I've been around.)
    Are you able to "front it" (whilst still on "duty.) & time your bolus for meals on the allotted breaks?
    If you eat something similar on your shifts every night, you may find a pattern? I empathise, not easy...
     
  9. Frankie_m

    Frankie_m · Member

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    Yeah I can front it although I’m almost certain I would have a hypo immediately after doing so unfortunately as the insulin just seems to take effect in literally minutes and food doesn’t have much effect unless the carbs are extremely high.
     
  10. Jaylee

    Jaylee Type 1 · Moderator
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    I would wager, you & I on the same shift with the same tasks would fair differently.
    We are certainly different ages.
    Throw me a "bone" here.. What do you normally eat to get you through a shift?
    When you go low. How are you treating it..?
     
  11. Frankie_m

    Frankie_m · Member

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    Usually like a large sandwich and flapjack/biscuits. When I go low I drink coke and have some biscuits.
     
  12. Jaylee

    Jaylee Type 1 · Moderator
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    Hi,

    Looking at your first post. You mention a hypo/plummeting BGs prior to your first break?
    Had you eaten prior to going to work, could you still have bolus insulin on board??
    I've known novorapid still have a lick in the tail nearly 5 hours later?
     
  13. Frankie_m

    Frankie_m · Member

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    I eat dinner around 2 hours before I start although I do account for physical activity with my bolus. Still manage to have hypos pretty consistently.
     
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