by mellow.cypriot

Hi everyone,

I was wondering if there were any nurses out there with hypoglycemia that could give me some advice.

A little background: I am a nursing student, and just recently (last month) developed reactive hypoglycemia. As if my nursing program isn't difficult enough, now I have the stress of needing to eat every 2-4 hours. If I don't (and even sometimes when I do), I will start sweating, lose my ability to focus, become severely impaired (it seems like I am intoxicated), and lose sensation in my extremities. After a good sized meal, I am back to normal. I recently got a blood glucose meter and have recorded measurements of 50 and 54 mg/dL.

I won't even mention the problems I have had with weight gain (haven't gained weight for 10 years, but have gained 10 lbs in 1 month). But here's what I'm really concerned about...How do other nurses with hypoglycemia work with this condition? Are the places where you work ok with you needing to take a break every few hours to eat? One thing I am especially concerned with is becoming impaired while on the job, and making a poor decision. I am worried that I would be passed over for a job for someone who doesn't have the potential to become severely impaired.

I am beginning clinicals in a few weeks and am worried because I am still trying to figure out how to manage my condition. Every so often I'll be studying and start panicking, thinking "I won't be able to cut it in nursing, I'm going to be resented by my bosses and coworkers and won't be a good fit...I should just quit!" and have to take a break to calm down (which is actually what I'm doing right now).

So if anyone has advice or information they could share, it would be extremely helpful...thank you!

Re: Nurses with Hypoglycemia?

this is/should be a very rare dx.....and bs in the 50's arent too terrible, since 60 is the low end of normal....gaining weight tells me you might want to check out metabolic syndrome.....and in the mean time, make those "meals" a little smaller,lol... sometimes the reaction is from the rate of drop, if you are actually running high and the body catches up/over shoots....this will give this reaction......i will stop now, before i get too far into MD territory, lol
however a second opinion from a endocrinologist would probably be a good idea.

Re: Nurses with Hypoglycemia?

Please make an appointment with your physician for a thorough physical. The weight gain you describe needs to be investigated beyond a vague diagnosis like "hypoglycemia."

Once that is done, if you continue to have fluctuations in your blood sugar, I would recommend a consult with an RD or a CDE. It is my experience that patients with unstable blood sugar levels (for any reason) fare best when they follow a diabetic diet and exercise program.

Fluctuations in blood sugar can be controlled and need not interfere with the practice of nursing, but to do so requires serious dedication to a well-balanced eating and exercise program. There are no shortcuts that work.

Re: Nurses with Hypoglycemia?

You're not the only nursing student with hypoglycemia if that makes you feel better. Remember stress does not mesh well with any type of blood sugar issues you may have. Since becoming a nurse can be moderately stressful it is extremely important to find ways to cope with stress.

I agree with the previous two people who replied and that a second opinion would not hurt at all. This would also give you additional information.

I found always keeping some kind of snack handy is a necessity. That is why I love scrubs they have nice pockets to store food in. It may help you to keep a daily food journal, document when and what you eat or drink and also when symptoms appeared. This helped me when I diagnosed to figure out what food items I can tolerate better and which ones I have more issues with. Oh and always eat breakfast....especially before clinical!

Re: Nurses with Hypoglycemia?

Thank you for the replies...I went to my 2nd doc who ordered some additional tests (the first series of tests were "normal" =/ ) and referred me to an endocrinologist. Besides a wound to my vanity, I don't think the weight gain is a serious issue...just the fact that I'm eating about 50% more per day than I used to before my issues developed.

And Jules88, it's nice to know that I'm not the only one who is going through nursing school with this issue. You're right...I have noticed that stress makes the symptoms much worse. Before I just used to ignore the stress and work through it, now seems I have to actually focus on minimizing it! For the best, I'm sure. Would you mind giving me any more advice on how you've dealt with your condition? And have you received a formal diagnosis, or just learned to manage it?

Thanks...

Re: Nurses with Hypoglycemia?

Originally Posted by mellow.cypriot

Are the places where you work ok with you needing to take a break every few hours to eat?

There are many, many places that are not ok with Nurses taking any type of break, not even to sit for 10 minutes.

Now, if you happen to be hired at a place that pulls this garbage, get a Doctor's note explaining that you require a break due to health/medical reasons.

Your condition may fall under the American's with Disabilities Act. Allowing you to have a snack/meal break every 2-4 ours is a totally reasonable accommodation.

From the eeoc site:
Is it a reasonable accommodation to modify a workplace policy?

Yes. It is a reasonable accommodation to modify a workplace policy when necessitated by an individual's disability-related limitations,(71) absent undue hardship. But, reasonable accommodation only requires that the employer modify the policy for an employee who requires such action because of a disability; therefore, the employer may continue to apply the policy to all other employees.

Example: An employer has a policy prohibiting employees from eating or drinking at their workstations. An employee with insulin-dependent diabetes explains to her employer that she may occasionally take too much insulin and, in order to avoid going into insulin shock, she must immediately eat a candy bar or drink fruit juice. The employee requests permission to keep such food at her workstation and to eat or drink when her insulin level necessitates. The employer must modify its policy to grant this request, absent undue hardship. Similarly, an employer might have to modify a policy to allow an employee with a disability to bring in a small refrigerator, or to use the employer's refrigerator, to store medication that must be taken during working hours.

Now, I understand you do not have IDDM, but if you do have these critical drops with your blood sugar and do need to have meal/breaks and/or snacks....keep what I posted in mind and check out the ADA website.

GOOD LUCK!!

Re: Nurses with Hypoglycemia?

Would you mind giving me any more advice on how you've dealt with your condition? And have you received a formal diagnosis, or just learned to manage it?

Yaay for advice..I'll try my best but remember everyone is different and unique--just like everyone else.
Basically I have learned to manage hypoglycemia and I was diagnosed with it in 1998 when I was about 10 years old. At the time my primary doctor ordered a glucose tolerance test, failed that test quite nicely(blood glucose readings in the low 30's..). I was told to eat every 2-3 hours. Went to a few specialists more random tests and they ruled out possible causes of hypoglycemia.

I still eat every few hours (granola bars). I don't follow an exact diet plan anymore, but I am aware of what I am eating and how my body may react to it. I try to eat some form of protein with every meal/snacks and end up eating many smaller meals a day. Be aware of what your eating is the best bet and think about how long that food item will last and when you will need to eat again. It is best to eat/drink something before you even get the symptoms of low blood sugar(easier said than done on some days though)

Let others know you have hypoglycemic tendencies and make sure they know the symptoms of it so they can yell at you to eat. It does help and makes you feel less alone.

De-stress!! writing in a journal, taking some time to color with crayons, just do something to help lower stress.

Hope this helps a tiny bit at least, feel free to ask other random questions.