I have been a type 1 diabetic for 13 years. I work in construction, and it’s a physically demanding job. I am having trouble keeping my blood sugars up while working. It goes down fast so I drink soda to get my blood sugars up, but it won’t stay up long even though I drink two to three which aren’t good either. I can’t keep doing that and am thinking about getting an insulin pump.
Most people who don’t get enough exercise and are at a sedentary job become insulin resistant. In your case, you are getting a lot of exercise and need more glucose to prevent a hypoglycemia episode.
A recent study found that reducing the dosage of the basal-bolus insulin and having a strategy for a low glycemic diet can prevent exercise-induced hypoglycemia.
Make an Appointment with Your Healthcare Professional Immediately
The good news is that you can work in construction and prevent hypoglycemia.
The first thing I would do as soon as possible is meet with your insulin prescribing healthcare professional. If you can also test and log your blood sugars, this will help the medical team adjust your insulin by observing when your blood sugar is more likely to drop.
Getting an Insulin Pump
Most Type 1’s that go on an insulin pump enjoy the freedom they have from not injecting insulin with a pen or syringe.
Some people don’t want a medical device hooked up to their body all day long, while others feel liberated once they are on an insulin pump.
Back in the day when I sold and trained on insulin pumps, I once spoke to a nurse who was getting lots of low blood sugars at work like you. Her husband was frustrated and asked me if going on an insulin pump will stop all the hypoglycemia episodes. I told him that it will not eliminate them, but most people will tell you it certainly minimizes the low blood sugars. A week later I followed up with the nurse and her husband. She was ecstatic to report, being on an insulin pump made her work day go smoother. She no longer had to take the time to treat the frequent hypoglycemia episodes she was experiencing.
Given your line of work and your erratic blood sugars you seem like a good pump candidate. However, there are criteria’s that you must meet to be considered for an insulin pump. Healthcare professionals that work with insulin pump patients will tell you; to be considered for an insulin pump, you must test your blood sugars at least four times a day.
Health Insurance Coverage
You need to have durable medical equipment coverage (DME) in your health insurance policy to have the purchase of your insulin pump covered. Depending on your insurance coverage there are other medical criteria’s that you must meet for the insurance company to pay.
Your healthcare professional who works in insulin pump therapy will help you figure out your basal (long acting insulin) and your bolus (short acting insulin) to tighten up your dosing to prevent and minimize high and low blood sugars.
If you decide you want an insulin pump, you can learn about all the different insulin pumps on the market with descriptions in this one chart.
Continuous Glucose Monitoring (CGM)
I would also recommend getting a CGM if your health insurance covers it or if you can afford the out of pocket cost. What makes this an essential medical device for you? The CGM will help you see when your blood sugars are trending up or down.
For example, if you are exerting yourself at work physically; you brake for lunch and before you take your insulin, you test your blood sugar, and it shows that your blood sugars are normal, you most likely will feel it is fine to inject your prescribed meal time insulin. If you have a CGM, it may show you that your blood sugar is trending down, so you may not want to inject the prescribed insulin because it will give you a low blood sugar.
Working with your physician is crucial. In your case, learning to adjust your insulin requires education and an experienced physician will help you minimize your hypoglycemia episodes.
Here is a CGM chart so that you may learn about the two that are available in the U.S. market today
You might also be interested in reading these stories about insulin pumps and CGM’s.
AskNadia and receive her unique perspective on your question.
Email Nadia at AskNadia@DiabetesHealth.com.
Nadia’s feedback on your question is in no way intended to initiate or replace your healthcare professional’s therapy or advice. Please check in with your medical team to discuss your diabetes management concerns.
Nadia was not only born into a family with diabetes but also married into one. She was propelled at a young age into “caretaker mode,” and with her knowledge of the scarcity of resources, support, and understanding for people with diabetes, co-founded Diabetes Interview now Diabetes Health magazine.
Nadia holds 15 nominations for her work as a diabetes advocate. Her passion for working in the diabetes community stemmed from her personal loss. She has used her experience as a caretaker to forge a career in helping others.