New Job

Hi All,
Was going to call my DSN but thought I might throw this problem open to the floor in the meantime.
Have just started a new job. Not only do I walk there but it is also a lot more physical than I expected it to be. I am hypoing ALL THE TIME and it is really getting me down. I've set all my ratios to 1:1 and am still hypoing as soon as 2 hours after breafast. Is 0.5:1 ratio possible? It seems so small to me. This is mainly about my breakfast injection, and even after the 1:1 ratio I still have many hypos. I then started to have a fiddle with my background (split levemir), cutting the morning dose by 10-20%. Still more hypos!

And the nighttime too is a bit of a mess. I might (for example) go to sleep at 7-8mmol/l, sleep the whole night through but then wake up hypo. This is a slight improvement from just having 3-4am hypos, but I don't really understand why it would happen (except for maybe the body replenishing stores during the night). It's stressing me out!

Any tips/ideas what is happening?
Also if anyone does a physical job...how do they adjust their insulin on days off?

Thanks,
Clare xx

Hi Clare, You seem to be having a bit of a nightmare at the moment.

I remember being told on our DAFNE course that the lowest ratio should be 1:1 so I think that maybe your best bet would be to try and reduce you BI by a bit more than you have already done. If you are having hypos throughout the day and night it seems that you are having too much BI.

With regards to your days off I would first try and get your BI correct on your working days because obviously having so many hypos is not good for you. If you find your BG is higher on your days off maybe you could increase your BI on these days. From what I understand Levemir changes work pretty much straight away so hopefully you might be able to work out what insulin you need on working and non working days.

Good luck!

Karen x

Hi Claire, don't worry about dropping to a 0.5:1 ratio. I've been using that ratio for the past two months and its worked brilliantly for me. 1:1 was given as a starting point, some people need more, some people need less. I take 0.5:1 on most days but if its my day off and im just watching tv and being really lazy then i can use 1:1. I find i dont need to adjust the BI. I think you still might need to lower your BI as you should be able to go to bed on that 7-8 that you mentioned and wake up somewhere in target. Don't worry about trying the lower ratio. If it doesnt work, you'll find out at the next meal and you can correct it, if it does work then you've avoided your lows!! x

I agree with Katy B, there is no rule that says you cannot use a 0.5:1 ratio. Any ratio is valid if it works for you ! I would say though its
worth you re-reading the section of the course on exercise ( either online or on paper). The effects of exercise can last a long time easily into the next day. I would suggest drop to 0.5/1 see how it goes, then adjust BI as well ( seperately of course, not at the same time !). Its problably worth you running high for a few days, just to ensure you keep your hypo warning signs and to try to fix the issue. Its not going to cause you a problem to run high for a week and then you can wind down your BG's and increase your insulins to get things back in line. How you adjust for days when you don't do exercise I guess is going to be tricky, it will be the next day most likely when you see the effects of no exercise NOT the same day. Unfortuantely I think its just trial and error, just like the rest of life :-)

Hi, I've just started a physical job too, 10 hours night shift so my BGs have been all over the place too. To fix the hypo problem out I've started having extra snacks (1 or 2 CPs) before work and then at break times. I'm still trying to get to grips with days off though, my BG is high every morning after sleeping although it's perfect when I'm working?? Linz

L McPhillips describing the Dawn Phenomonon..........