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Any night shift nurses with diabetes?

I was just diagnosed yesterday and am wondering how hard it's going to be for me to control it with diet or if it makes any difference eating during the day some days and nights the others. I was put on Glucophage, so I'm not treating it with diet alone. So, maybe that will help. Any tips? In case you're wondering, blood sugar in 300 range.

Nobody?

traumaRUs, MSN, APRN, CNS

Specializes in Nephrology, Cardiology, ER, ICU.

Hi there - I'm sorry that I can't help with advice, but I do wish you the best.

I don't have dm but have reactive hypoglcyemia. I've worked the night shift for about 5 years. Ive always talked to my manager about my situation and they have been supportive and understanding. There was alot of trial and error in the beginning to find out what worked to keep me balanced. It took about 2 mos work with my docs and dietician. Now, When I work I set the alarm on my watch to remind me its time to eat and I make sure I drink plenty of water. My co-workers are generally supportive and helpful about the situation. For me it's doable. It can be tough at times, but I manage. I wish you the best. Good luck!

kat911

Specializes in ICU, ED, Transport, Home Care, Mgmnt.

If you were just diagnosed you probably haven't had your Nutrition consult yet. You will be given your calorie count for the day as well as how many grams of carbs and protein you should consume with meals. After working nights, if I want to stay up on days I just have meals every 5-6 hours(check with your dietician). It usually works out in the 24-48 hour time period, I'm on Lantus) It is better in the long run if you can keep a steady schedule, but working nights that is very difficult to accomplish, and have a life. Over time you will figure out what works for you. Good luck.

bagladyrn, RN

Specializes in OB.

I read this with great interest as I am in the same boat - newly diagnosed diabetic working nights. To make things even more interesting, I'm a travel nurse and the diagnosis came 4 days before I left Florida to go to a contract in NH! So no dietary consult, minimal follow up and no one local that I know to ask. I'm just kind of "winging it" on this one.

I'll be following this to see what you find out.

kat911

Specializes in ICU, ED, Transport, Home Care, Mgmnt.

bagladyrn-You might want to consult the ADA and see what information they may have for you to help with your diet.

They have a magazine called Diabetes Forcast you can get if you join the ADA, I think it cost 25 a year. Good magazine, you may be able to access it on line since you travel. There is bound to be information out there for you to access. Check around for a Diabetes Nurse Educator or a NP who deals with a lot of diabetics, you may be able to tap into one of them for information and guidance.

Thanks for the imput. I wasn't given any info on diet or referral to a dietition. He just said, "you're a nurse and know what to do". :angryfire That really ticked me off and I wanted to say, "look mister, I'm a paying customer and I want what everyone else is getting with this diagnosis." Of course, I didn't say that though. I am going to go to a different doctor for my follow up instead.

AuntieRN

Specializes in Med/Surg.

SCRN1...I was also in your boat. I was diagnosed I think its almost 2 months ago now. When I was on nights I could not get my bs below 300 no matter what I did...I am now on days and can usually keep them under 225 which is still too high I know...but better then the 300's. I also find that mine are lower in the evening when I get home vs when I first get up in the am. I wish I had some answers for you...I just wanted to give you some support and when I go back to my doc next week if I learn anything new I'll share it with you...I also got the ....You're a nurse ...you work at the hospital...blah blah blah...just cuz I am a nurse does not mean I know everything...perhaps you could ask your diabetic educator nurse if you have one at your place of employment for help. (just an afterthought)...good luck!!!

AuntieRN, how did you manage with eating on the nights you worked? Were you able to eat a little something about every 4 hours? I work 12-hr shifts and am afraid I won't be able to eat often enough to keep my blood sugar stabilized once (if) I get it down. I'm trying to think of little snacks I could take to eat that don't require any refrigeration or heating because of limited time. It also concerns me that 3 days a week, I eat nights and the other 4, eat days. So that in itself isn't very good.

I have been checking my blood sugar over the weekend more often than the BID the doctor told me to just so I can get an idea on when my blood sugar is higher so I can start realizing what my body is telling me. Does that make sense? It has helped. At times, I'll feel the thirst & fatigue, along with polyuria and check my blood sugar & it's in the mid-300s. Then other times, I'll all of a sudden feel hungry and a little nausea and when I check it, it's dropped to the mid-200s (I know, still too high) and if I eat a light snack, I'll feel better.

I had to realize I would feel terrible until I got my BS to an acceptable level. I was 500 when I was given a diagnosis. YEP! Strike level. I would not take my BS level more than BID until I have been on the med for 2 weeks, remember it takes time to get to a viable level. Eat free foods, celery is great, green pepper strips, carrots. I do know there is sugar in carrots, but raw is best, sugar is not as high. Drink 6 to 8 glasses of water while at work, rest during the day. Find a MD who is good with diabetes. I am 12 weeks past diagnosis, BS level is 130 and conts to go down, I have lost 9 3/4 lbs, and I am walking, walking, walking. It can be done. Good luck.

Congratulations, gitterbug, on getting yours under control & the weight loss. I was told not to exercise until mine is under 240, so I guess the only exercise I'll get until I can get it down is at work and doing the daily tasks. I feel I've wasted all weekend though because I've been so tired, all I wanted to do was sleep. I know it's going to take a little while to get it down, but I was checking my blood sugar when I had different symptoms so I could get a better idea of what it was so I can later tell (like when I'm away from home & glucometer) what's going on...whether it's up or down. I feel so horrible with the range mine has been in, I can't imagine how bad someone else feels with it even higher. I guess different people feel different ways. I've taken care of patients who've had it in the 600s and denied any symptoms or around 50 with none too.

AuntieRN

Specializes in Med/Surg.

SCRN...no I could not get my sugars under control working nights. I was always messed up between day and night...I asked my doctor how to do it and he told me it would just be trial and error...that was not good enough for me...I am on days now...the days I work my sugars seem to be better at night when I get home...but still high in the am when I get up...the days I am off they are all over the place...there does not seem to be any consistency in my levels regardless of how or what I eat.

SCRN and AuntieRN......Please see a Diabetic Educator if possible. These people are specificly trained in diets and exercise for DMI and DMII, they can help you with a diet for working nights. They can teach you how to adjust your diet when you go from working nights and for when you have days off and eat during the day. They can help with an exercise plan to help maintain lower blood sugar levels. I'm insulin dependent and on a pump, my educator was a major help in maintaining my A1C's to about 7. Diabectic Educator, that's the way to go.

BackPackerRN

Specializes in ICU, CVICU.

SCRN1, I will share my story and see what you think. My husband is a diabetic, started out in the 400's. Would usually get hypoglycemic symptoms when he dropped to the 300's. He was initally started on Actos which brought his A1C's down to 6 (He refused to check his blood sugars). However the actos caused him to retain fluid and started having difficulty breathing. Our MD would not listen to us so he (one who does not like MD's in the first place) quit all his meds (he was also on vytorin) and deceided he could do it with just diet and exercise. Three months later he started having chest pain (not related to DM but WPW) and got freaked out and deceided maybe doctors aren't that bad after all. We found another doctor who starts him on Amaryl as his A1C was 13. He starts taking his BG when he wakes up, but can't get his fasting below 250. Despite increasing his doses and adding Avandia his BG's don't budge. In the meantime he has an ear infection that won't go away no matter what we throw at it.

We finally deceide maybe it is time to start insulin. If nothing else to give his B-cells a rest. Our MD thinks he might be able to get off the insulin at some point if he hasn't totally destroyed all his B-cells by overworking them. Anyways, he started levemir at 5pm and regular before meals. We both work nights so he has a similar issue that you do. He always takes the levemir at the same time each day-5pm. Then he has sort of a sliding scale that he uses before each of his meals. The time of his meals changes on a day to day basis but with using insulin we have been able to keep a good control of his blood sugars He now ranges from 89-150, which for him is great. He is also getting tighter control as we experiment with his carb to insulin ratio and levemir dose. I know it feels like a big step to go to insulin but I think it was worth it for my husband. He feels so much better now and his ear infection cleared up quickly. He also stopped his oral meds, which he enjoys not having those side effects and not having to take so many pills.

By the way I think symptoms depend on where your blood sugar levels live. Initally my husband was in the 400's without symptoms and could have been there for years. His body finally quite compensating and he started having more symptoms. Also we have noticed that no matter what his starting blood sugar is, if he drops much more than 70 points in a short amount of time, say 2 hours, he feels hypogycemic. So if he goes from 300 to 220 he is about ready to pass out.

Good luck with your diabetes. Going to days would probably help things out but I know how hard it is to get a day shift sometimes. I had worked my way to a day shift on my prior unit only to end back on nights when I moved to another unit. I love where I work but it has a 2 year waiting list to get to day shift. At this point I am not willing to find a new job just for a day shift.

BackPackerRN

Specializes in ICU, CVICU.

While I was writing my novel ilostu12 posted one. I agree with seeing a diabetic educator. We have been seeing one and she is very helpful. They have a lot of insight that sometimes an FP MD doesn't have.

nursemary9, BSN, RN

Specializes in Psych, Med/Surg, Home Health, Oncology.

Hi

I work nites for MANY years.

I have DM.

I started out with sugars in the 450 range.

I started out with a HgbA1c of 14.

#1. YOU NEED TO SEE A DIABETIC EDUCATOR. You need to go back to your Primary & ask for consult!! This is so important.

I didn't ever see one & really wish I had. I saw a dietician about a year ago for another reason & learned so much.

Try to get that sugar down with diet & the glucophage they gave you.

I really feel that the more meds you are on for DM, the more problems you have.

Try to take meds the same time every day.

Diet, Diet, Diet

Watch those carbs!! Keep them down.

Do you know about complex carbs? These in moderation are good for you.--thats why you need a Diabetes educator &/or a dietician--preferably both.

I am now only one one med & my lasy HgbA1c was 6.0. My usual sugars are now between 70-90. If I go into the low 70;s tho, I get a bit shaky.

I can't say it enough--you need a professional to help you out

Mary Ann

kat911

Specializes in ICU, ED, Transport, Home Care, Mgmnt.

I had trouble keeping my sugars down because of my work schedule, I am sometimes on all three thifst in a weeks time. I was put on Lantus and that helped tremendoulsy. My HgbA1C's are WNL. I alos take Avandia to make my body more receptive to the insulin. The lantus works great no matter what my schedule is or when I need to eat.

chander12

Specializes in ICU AND CVICU.

Thanks for all information I got I was diagnosed with type II DM last month and my fasting blood sugar was in 135-150 range. I am on Metformin now and fasting blood sugar has come down to 120 range. The problem I face is not fix time for meals at night shift some times at midnight or sometimes at 0200. I walk approx 1.5 miles perday. and I am going to attend 10 hours class on diabetes self management.

But I still feel tires all the times any suggestions

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