Newbie looking for advice

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admiralandrea

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Type 2
Hi,

I'm Andrea, 52 years of age, type 2 though I do inject insulin as well as taking various medications. I'm looking for advice anyone might be able to offer around working shifts as my job has been reorganised and I will now have to work 24/7 shifts including overnight. I have no idea how to manage my eating/medication and although I hope to get a GP appointment to discuss this, I thought I'd see if anyone had any experience or suggestions they'd be willing to share.
 
Welcome @admiralandrea 🙂 Most important question: what insulin(s) do you take (full name including any letters or numbers)? Some insulins and insulin regimes are more flexible than others. If you can tell us the precise information about your insulin that will help a lot.

Will your overnight shifts be regularly? How many a week?
 
Is you job active or sedentary? I find dealing with bs whilst being active more tricky than if sitting
 
Welcome to the forum @admiralandrea

We’ve had a few shift-workers on the forum over the years.

It can be a bit challenging to get your diabetes settled into a rhythm with shifts, depending on your pattern and how often you have to switch between daytime and nighttime working.

In the short term I find it easier to basically leave things as they usually are as regards mealtimes and doses etc. But if you are going to spend longer periods working through the night such that your hormonal/circadian rhythms begin to shift and adapt, you may need to make some adjustments between your shift phases?

Which insulins are you on?
 
Inka said:
Welcome @admiralandrea 🙂 Most important question: what insulin(s) do you take (full name including any letters or numbers)? Some insulins and insulin regimes are more flexible than others. If you can tell us the precise information about your insulin that will help a lot.

Will your overnight shifts be regularly? How many a week?
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I take lantus insulin, it's supposed to only be at night time but a few years ago, I was told to start injecting it in the mornings as well. I use 26 units in the morning and 6 at night.

It's 2 night shifts a month.
 
everydayupsanddowns said:
Welcome to the forum @admiralandrea

We’ve had a few shift-workers on the forum over the years.

It can be a bit challenging to get your diabetes settled into a rhythm with shifts, depending on your pattern and how often you have to switch between daytime and nighttime working.

In the short term I find it easier to basically leave things as they usually are as regards mealtimes and doses etc. But if you are going to spend longer periods working through the night such that your hormonal/circadian rhythms begin to shift and adapt, you may need to make some adjustments between your shift phases?

Which insulins are you on?
Click to expand...
I inject lantus insulin mornings and night times, as I said above. Though it's supposed to only be night time. I am wondering whether to ask about going on to something different. I've recently moved and when I had an initial appointment with the specialist diabetic nurse at the GP practice she mentioned that - going on to something newer, but changed her mind when she saw my blood test results and because the change was made by a hospital based specialist nurse.

It's only 2 nights a month, so I'm hoping I might be OK with not making changes. The latest finish on my other shifts will be 10pm, so I should be able to otherwise stick to my same routine of meal times etc.
 
It may be that adding a mealtime insulin gives you a more flexible system. That way you can use Lantus to just support your background needs, and use meal-specific doses of rapid acting insulin whenever you are eating (day or night)?

Hopefully a couple of nights a month won’t upset your metabolic rhythm too much, and you’ll just be able to keep things pottering along to suit the rest of your schedule, with a bit of adaptation on your night-shift days?
 
everydayupsanddowns said:
It may be that adding a mealtime insulin gives you a more flexible system. That way you can use Lantus to just support your background needs, and use meal-specific doses of rapid acting insulin whenever you are eating (day or night)?

Hopefully a couple of nights a month won’t upset your metabolic rhythm too much, and you’ll just be able to keep things pottering along to suit the rest of your schedule, with a bit of adaptation on your night-shift days?
Click to expand...
I'm far from an expert in this discussion. But as I read the opening posts it struck me that Tresiba basal, once daily, could cover much of the problem with bolus for meals (or corrections when appropriate/needed). I sometimes stay up all night, for social (or medical) reasons and my Tresiba successfully carries the irregular background need, but backed up by NovaRapid being available. On these all-nighters I maintain my daytime meal routines and snack on very low carb things if I get hungry in the small hours. I usually do this while still at home, with the convenience of being able to forage for whatever is in the cupboards, but have had a couple of drives through the night with a modest selection of suitable snacks handy
 
admiralandrea said:
Hi,

I'm Andrea, 52 years of age, type 2 though I do inject insulin as well as taking various medications. I'm looking for advice anyone might be able to offer around working shifts as my job has been reorganised and I will now have to work 24/7 shifts including overnight. I have no idea how to manage my eating/medication and although I hope to get a GP appointment to discuss this, I thought I'd see if anyone had any experience or suggestions they'd be willing to share.
Click to expand...
As you’re only on basal insulin then there should be no problems with working shifts. It would only be if you were on mixed insulin that you would need to make sure you got breaks at predictable times to eat. You mention having an otherwise set routine of mealtimes, is this because you think it’s necessary or personal preference? You shouldn’t need to have set mealtimes on lantus, if your dose is right you should be able to eat nothing all day if you wish with no problems at all.
 
Lucyr said:
As you’re only on basal insulin then there should be no problems with working shifts. It would only be if you were on mixed insulin that you would need to make sure you got breaks at predictable times to eat. You mention having an otherwise set routine of mealtimes, is this because you think it’s necessary or personal preference? You shouldn’t need to have set mealtimes on lantus, if your dose is right you should be able to eat nothing all day if you wish with no problems at all.
Click to expand...
Keeping to a set routine is personal preference, I find it easier to manage my life that way!
 
admiralandrea said:
Keeping to a set routine is personal preference, I find it easier to manage my life that way!
Click to expand...
Personal preference is fine, was just checking to make sure you hadn’t been given any dodgy advice about having to eat at set times, and so mistakenly thinking shift work would cause a problem with that.
 
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