One of the biggest challenges for individual with diabetic is taking the responsibility to take care of your own diabetes management. It is unlike pain killer, where you take the pills and the pain will remove in 2 hours. It involved medication, menu planning, physical activity and the tips to manage hypoglycemia.
Self care also means that you have to understand the diseases inside out so that you can make a better choice. Even though diabetes is well-managed, however, shift work might increase the risk of hypoglycemia (low blood glucose) if you are on oral medication or insulin injection. One of the reasons is because the body’s internal clock will be disrupted when we are eating and sleeping at a different time. Thus, it will affect the blood glucose level. Besides that, shift work can cause mental and physical stress which will affect the blood glucose control.
Talk to your employer
When I said talk to your employer is not about asking for special treatment. It is about letting him or her know that the things that you need in order to have a better control including regular meals, frequent and short break time, access to blood sugar meter and so on.
Self Monitoring Blood glucose (SMBG) is one of the most effective tools to monitor your blood sugar level anytime, anywhere. By understanding blood glucose level, you are able to identify the problem and fix it at the same time.
It is important to check your blood sugar level on a regular basis. When you first start your job, you should check your blood sugar before a ‘new’ meal or ‘new’ snack. Besides that, it is crucial to check your blood sugar every 2-3 hours when you are working night shift. When you know how you blood sugar works during night shift, you do not have to check every 2-3 hours anymore. After checking your blood sugar level, keep a detailed record of the readings including time, food that you eat and medication taken.
Regular timing is crucial for diabetic patient. Besides that, small and frequent meal is advisable especially for people who are on insulin treatment and oral medication. The basic guideline is to include evenly spaced out meals which is 4 hours interval and snack (if requires).
For people who are working midnight shift, they should take balanced meal before 1 a.m. A balanced meal means that it consists of carbohydrate, protein, fats as well as fiber. In a plate, half of the plate has to be green leafy vegetables as this is because it is higher in fiber. Another quarter of the plate is filled with protein sources for example grilled chicken, fish, tauhu or egg. Another quarter of the plate would be the rice (one medium bowl or 3 ladles). Sandwiches from home are a good option rather than food from fast food outlets.
At the end of the shift, take a light snack before go to the bed. You could consider low fat milk, plain yogurt, fruits, sugar free drinks and crackers.
For those who are on insulin, there would be a risk of getting hypoglycemia (low blood sugar). If this is your first time working for night shift, talk to your doctor and he will make insulin adjustment for you. Hypoglycemia can occurred with increased physical activity, peak action of insulin or diabetes pills or delayed meals and skipping of meals. You have to recognize what are the symptoms of hypoglycemia such as feeling weak, headache, shaky, fast heartbeat and sweaty. If you are experiencing such symptoms, prepare your blood sugar meter with appropriate treatment. If the reading shows that you are having low blood sugar, immediately treat with fast acting carbohydrate such as 3 unit of candy, 1 tablespoon of honey or 1 cup of orange juice. After 15-20 minute, recheck your blood sugar to ensure that it is back to normal. It is important to carry these food sources with you all the time.
It is important to be physically active even you are working night shift. I understand that it is hard to keep up with the regular exercise. There are a few ways to increase physical level such as talk a walk during your break time, use the staircase instead of the lift, do some stretches at your work place.
Generally, the best time to exercise is after a meal where the blood sugar tends to be higher. When returning from home after midnight shift, exercise after a morning meal would be a great time. Exercise will help to reduce stress and improve quality of life.
Take home messages:
- Do not give up on self management for diabetes even though you are on night shift.
- Check your blood sugar and record the readings (Bring the records to doctor and dietitian)
- Have regular, small and frequent meals throughout the day.
- Make sure that fast acting carbohydrate is always there in order to treat hypoglycemia.
- Make sure that you have snacks around work place.
- Be more physical active.
- Consult diabetic care team including doctors, pharmacist and dietitian to develop an individualized plan for diabetic issues.