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Hypo at work. Every day.

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Lauren

Lauren

Well-Known Member
Relationship to Diabetes
Type 1
Hi all

Some of you may know that I work shifts and this has been affecting my levels a bit. Recently my BG has been below 3 everytime I get home from work.
I'm on a pump and have the temp basal on when I'm at work, and depending on the shift I have it on at a different percentage, depending on the time of day. Because my BG has been low everyday, I have been decreasing the amount and now I have it on 60%, but I still have hypos. So this week I have been bolusing for only half of my lunch, putting my basal on 60% and having a 15g carb snack halfway between lunch and hometime but I am still going low. And last week I felt so awful that I suspended my pump for two hours but when I got to lunch my BG was only 3.9. I have changed my usual basal settings too.

Just not sure what else I can do. I'm worried I'll get awful complications from this. Has anyone else had any experience of this? I will definitely be bringing this up at my appointment in May but in the meantime any advice would be greatly appreciated 🙂
 
I don't use a pump so can't offer too much advice. My suggestions would be adjust again or think about taking more carbs and phoning doctor or DSN for further advice.
 
Hi Lauren, it sounds to me that you are doing all the right things, but just need to go further in order to find the point at which the insulin is right to match your requirements in this new situation. It can be surprising how much insulin requirements can decline in certain situations, but it's better to do it incrementally so that you don't have any big shocks. Although the numbers you are reporting are low, they are similar to what a non-diabetic would get so you shouldn't worry about complications from them. The main thing would be that if you are driving home then you probably need to make absolutely sure you are safe to do so for the journey 🙂
 
Sounds very frustrating Lauren, but I think you are doing all the right things.

Just keep reducing basal patterns until the TBRs etc begin to work OK.

At various times my 'basic' pattern has gone up or down by almost 50% (low 10.x to high 14.x). The annoying thing is that you have to take these adjustments quite gradually and endure the lows/highs until you find the new 'normal'.

Equally frustrating, I find, is when you expect something to happen (basal needs rising when general amount of exercise/activity drops for several weeks/months) but exactly the opposite thing happens!

Sometimes you just have to roll with it I think. If you don't expect your D to be logical and predictable and just go by test results you can't go far wrong 🙂
 
Thanks for your advice guys. I'm relieved to know I'm unlikely to get complications because of these lows, hopefully I'll be able to sort them soon. I suppose I'm just going to have to test more at work. It will be nice when I can see exactly what my levels are doing on each shift.

I don't drive Northerner - I am too frightened I'll go low and crash! I'm very lucky though that I have a slave to drive me around when needs be (my husband) :D
 
Hi Lauren,

I don't know which pump you have? On the Medtronic Veo you can set a separate basal pattern for days which have a different routine. So for example if your BG levels are ok when it's not a working day, you could use your standard basal pattern, then programme one (called Pattern A on the Veo) with reduced basals to use on working days. This saves having to use temps all the time - if you find yourself using a temp basal all the time, it means you need to make a long term change to the basal for those days. It sounds like you just need to reduce your insulin even further on work days.
 
First i would go back to basics, so try fasting and check your blood as often as possable (i did this every hour) and get a good idea when things are starting to go wrong. And because you work shifts, there can be a lot of testing. Is your job the same every day?? also what carbs are you having?
What i personaly have found is because i have lost a bit of weight, i have had to cut my insulin by 20% over all.
Do you have a drink when you get home?? as i find if i have just one glass of wine, i have to take less insulin the next day as all i do is hypo.

I know its a pain, i seem to get mine working, then it all goes out the window.

Good luck.
 
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