Shift Work and Diabetes

I’ve been gone from the “blog-osphere” for awhile. Life. Diabetes. Those two things in and of themselves can take up all of my time. Plus, I work in television news production which is a 24/7 operation. Yesterday my shift was from 8pm to 4am and I had to be back at work by noon today. This would be a challenge for anybody. Add Type1 diabetes to the mix and the challenge becomes a thousand times more difficult. There are numerous articles about the negative effects of shift work – webMD – but I don’t need those articles to know that shift work has many negative side effects. I do whatever I can to mitigate those negative effects.

When I was first diagnosed with diabetes, 36 years ago, the regular schedule of insulin shots, food and exercise were critical in maintaining good control. Even then, my schedule was less than regular I was able to establish a fairly structured routine and I credit that for my stellar control in the early days with diabetes. I was able to transition from television production; which often requires very early starts and very long days in various locations, sometimes with limited access to any food no less healthy food; to television post-production. Post-production generally starts a little later and I stay in one place with a refrigerator nearby. When I was doing Multiple Daily Injections (MDI) being near a refrigerator was a requirement. As an editor, the hours are also very long and I sit for long periods of time. Basically, television is not the best line of work for people with diabetes but having food nearby and staying active outside the edit room keeps my diabetes management under control. However, the lack of a steady schedule, eating take-out and delivery food all of the time and those long stretches of no physical activity make healthy living nearly impossible.

How to adapt? First and foremost, a healthy diet. That means bringing lunch and healthy snacks every day. Instead of doughnuts, cheeseburgers and pizza everyday eating homemade salads, leftover healthy dinners, fresh fruits and nuts make blood sugar control a little easier when I’m out in the world. Granted, it is not easy when everyone else is ordering fries and milkshakes but the trade-off makes hyper- and hypoglycemia less frequent. The one thing no one needs during a stressful work day is a severe hypoglycemic reaction that brings confusion and an inability to function efficiently or hyperglycemia that fogs the brain and slows the body. No one wants to have to call 911 during the day and I have always felt an immense responsibility to not burden my co-workers with my disease. That said, I am also very open about my diabetes. I tell co-workers that I have type1 and I also tell them how to deal with me if they notice hypoglycemia before I do… which, luckily, has never been necessary.

Secondly, blood tests and a continuous glucose monitor (cgm). There is no replacement for knowing what my blood sugar is. Before I had a cgm, I easily did 10 to 12 blood tests a day, right at my desk/console. With a cgm I still do 3 or 4 blood tests a day and I am very tuned in to my iPhone’s cgm display. If I am eating right and I am aware of my blood sugar I minimize any possibility for hypoglycemia. If I do get a low blood sugar alert I react immediately. I think reacting to the data is paramount to staying in control and not having co-workers have to deal with my negligence. Sometimes a low blood sugar is not negligence but not reacting quickly is. I am also on an insulin pump which has helped heighten my hypoglycemic awareness. The pump along with cgm alerts help tune you in to what you feel like when your sugar is falling or rising rapidly. Being aware of the subtle changes in mood or physical differences helps me stay in control throughout my day.

Finally, exercise. Admittedly, this is an area that I still struggle with. I ebb and flow with exercise. I try to get my 10,000 steps in everyday. Key word, “try”. Working in New York City helps since city working makes walking part of everyday so even on a bad day I am getting a minimum of 7,500 steps. I make sure I get up and walk everyday but sometimes the walks have to be short since I am in a deadline business. I must be mindful of getting enough exercise in to help manage my blood sugar. Regular exercise is paramount in maintaining good blood sugar control. In addition to all the walking I have also begun doing a daily or every other day strengthening routine. Find something that works for you and your schedule and stay on it.

Bottom line, shift work is difficult but it is manageable. I have worked shift work into my diabetes life successfully if somewhat reluctantly. Do I love it? No but I do love the work I do so I am able to adapt to the shifts as they come my way. I work with my healthcare team to build a shift pattern for my basal rates and an adaptive bolus schedule for my shift work. It is not always easy but, Life. I do what I have to do and pay close attention to what I need to do it successfully.

Stay positive and meet the challenges head on.

 

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