Severe Hypos at Work
Hi, I’m new to this asking for help thing and online community. I’m 25 and have been T1 for 15 years now.
But I’ve been struggling with low sugars at work (I work in retail) and a few have been severe where I needed help from others. I fear that if it continues and gets worse then I could lose my job. I’ve tried to plan break times and eat more but I’m sometimes too work focused and don’t take a break for 3 or 4 hrs. I also have a poor appetite, not sure if this is diabetes related but I’m aware it’ll increase risk of hypos. Any advice would be helpful. I’m also worried about how my managers and colleagues are going to react after my latest hypo.
OK, there are, as I’m sure you know, several variables to handle here. First, do you eat many carbs, especially for breakfast? Since carbs convert to glucose immediately, but only last for 2 hours or so you tend to go low after that point. If you eat more good fats and proteins. in that order your endurance should improve greatly. Reserve carbs for emergency lows, but them down other times. Fats will last longest and supply more energy than either proteins or carbs, in that order.
Download the PredictBGL App to your phone. With it, you will see which doses are wrong and how to fix them. Once your doses get better, it can predict them more accurately.
I’m not sure on my carb intake, it’s not something I’ve learnt. I haven’t been on any of these courses. But I’m pretty sure breakfast is my best meal. My lows tend to happen between 2pm and 8pm. I take 2 injections a day of humalog mix25. 28 units in morning and 18 in afternoon.
What do you mean by good fats etc?
if you mix carbohydrates with fats, your body will absorb the carbos more slowly. This can be helpful if you have “marathon” work shifts. “good” fats might include something like olive oil, which can help increase your “good cholesterol”. “Bad” fats like ice cream for example, make the carbs very slow to absorb but can raise your “bad” cholesterol”. Your mileage may vary.
you can mix carbohydrates with proteins as well, and get nearly the same result.
i am not a doctor, but your insulin mix (if includes NPH type insulin) can have a peak (where your insulin is absorbing fast and your blood sugar is dropping) at somewhere about 4-6 hours after injection. This can be troublesome. We used to call this NPH feature “the tail” because of that peak. there are different long lasting insulin formulas our there that do not peak the same way. if you have access to a CDE or endocrinologist – it’s way better to ask them than it is to experiment if you are uncomfortable.
when I am on a construction site, I have fast carbs in my pocket. it doesn’t take more than a second to pop 3 glucose tabs and chew them up. they work in 10-15 minutes. I also think a can of coke or gatorade by the register would come in handy. In the US, you can’t get fired for being diabetic, you can seek assistance from the ADA (Americans with Disabilities Act) you can look here https://www.ada.gov/qandaeng.htm
i just saw you are from the UK – sorry about the US references but I am positive there are disability guarantees where you live as well.
Though you are i n the UK there IS discrimination protection known as the DDA, look at:
As was said, good fats are things like virgin olive oil (if real, many are poor fakes despite the label), and much better, coconut oil. The only thing I cook with is coconut oil, since olive oil break down with heat, and coconut oil doesn’t.
Thing is that most vegetable oils, such as canola oil, turn into tans fats when you heat them up, and trans fats are now recognized as the worst thing for your bloodstream.
Another factor that affects many people’s thinking is cholesterol, which we have all been warned about controlling for the last 50 years or so. Problem with that is that ANYTHING you’ve heard about it is wrong, from the start. Cholesterol does NOT clog the arteries causing heart attacks and strokes, this is caused by inflammation in the artery walls that blows out under stress, blocking the blood vessel. More important, fats that we eat don’t create cholesterol plague in the arteries, that is created by eating grain products, which raise blood glucose levels creating damaged red blood cells that tangle with others. These penetrate the artery walls creating a pocket full of pus and dead cells.
Fats are now starting to be looked at in standard medical practice as being the best kind of nutrition, since they last longest, which helps your situation to an extent, and cause no problems, since they don’t involve turn unto glucose and involve insulin, they become ketones, which are a much better energy source for the brain than glucose anyway.
Getting back to the original problem, it’s always best to carry glucose tabs or candy to take when a hypo starts affecting you, though liquids, such as a soda pop to drink may be absorbed faster. I’d also suggest that you stop taking a combination insulin such as Humalog 25. Thing is that it locks you into a situation that may be causing your problem. When you take the 2 kinds of insulin separately you can tighten control by adjusting whichever one is wrong for that day. With your situation you may find that very helpful, just reduce the slow insulin dose slightly to give you better endurance in the afternoon. Then if you are higher at suppertime you can take more Humalog to counteract the high that resulted.
Of course if you DO go low carb by eliminating grain products from your diet your insulin needs will go down a fair amount, and must be adjusted to fit that. The other point is that the less insulin you need to take the less variability will affect you. Ypu said you take 46 units per day, I take about 25 a day total since I low carb. See if you can find Dr Richard K Bernstein’s book “Duabetes Solution”, he explains it very clearly, understandable by anyone.
When I was a new nurse I had the same problems. Unfortunately I have hypo unawareness. I can get down to 40 and function fine but, definitely NOT GOOD when caring for patients. I always carry an 8oz coke either in my jacket pocket or in my bag. It’s really quick and helps with nausea…one thing that tells me to test ASAP. I tell a coworker I need a couple of minutes and they cover me so I can eat some cheese and peanutbutter crackers, which also helps with nausea. I’m on multi injections and adjust my insulin accordingly. If you’re not sure what to do call your doc.
I’ve had diabetes x45yrs and until my 30’s, I admit to being embarrassed about telling people. I never asked or pressed to take a break.
I know ridiculous, right?
I finally realized “Who cares?” I wasn’t a criminal so why was I hiding? Now no matter where I’m at, I don’t hesitate to treat my low.
Don’t worry about losing your job. It would be illegal to be fired because you need breaks to care for diabetes. Check out #reasonable accommodation in the work place.
So sorry. Didn’t realize you’re in the UK. I’ve heard of a great organization in the UK which you know better then I would. Consider researching employment laws + diabetes. Don’t hesitate. No one deserves to lose their job because of a preexisting condition.
Hope some of this helped.