Nurses with Diabetes

grannynurse FNP student · Apr 7, 2006

My life changed this week. I was diagnosed with Type 2 diabetes. Fasting bs in the 400s My doctor is wonderful....started on metformin, up to 1000 mg today.
My fasting was 256 this AM...and I am struggling to get it into normal range. BTW, I have had my days off during this. My questions are:
1. Should I return to work with high blood sugars? I noticed I had a headache, felt tired and grumpy the last several shifts I worked before I was diagnosed.
2. How does one manage this while working on a hectic Med/Surg Tele unit, working 7 PM to 7 AM 3 nights/week?
Thanks in advance for your advice. :bowingpur

What do you mean by high blood sugar? If you are referring to your 256, no you should not stop working. I know that you are a nurse but you need to get some current information about the management of our disease from specialists. By specialist I mean you need a consult with an endocrinologist, a diabetic nurse educator and a diabetic registered dietician. And you need to seek out community support groups and diabetic education groups. This disease is a complex one that many believe can be solved by just controlling one's blood sugar. You do not know the amount of micro damage that has been done to your cardiovascular, renal, neurological and optomological systems wqhile you went undiagnosed. And it may not be apparent yet. The number of diets and recommendations are numerous. You need to detemine which best suits you an you can do this by testing your blood sugar two hours after eating. You need not be discouraged if your blood sugar does drop to 120 right away. You need to set small reasonable goals to reach, in your blood sugars, diet, excerise and weight loss(if needed).

As for your second question. You may have it better then someone who works days. You do need to eat three meals a day and they need to be spaced out. Your drinks, on your shift, should be non-sugar such as diet soda, tea or coffee with artifical sweetners.

Good luck and welcome to our select club

Grannynurse:balloons:

cinnyluvscats · Jul 17, 2006

I am in a similar boat with you. Just got diagnosed with Type 2 last week myself. I'd had the classic symptoms for about a month and decided that denial wasn't working. I drank like a thirsty camel and lived in the bathroom!

My job is at a local health dept. with super staff who have been really supportive. Fortunately, I can eat and drink as I need to most times.

Any general advice from fellow diabetic nurses?

Thanks!

Cindy

achot chavi · Jul 19, 2006

1.Your blood test should include an HBAIC (glycosylated hemoglobin) and go to an Opthalmoolgist to check your eyes for damage.

2.You need to see a good dietician and tell her to treat you like a grave digger and not like a nurse!! You'd be surprised the things we don't know

3.Join a Gym and if you need to - lose weight Grab a friend, spouse,or child and go walking every day

4.If you smoke -try quitting - it could save your life!!

5. Start taking good care of your feet- Never walk around barefoot, Always stick your hand in your shoe to make sure that it is free of stones or objects that you might not feel but can cause a serious ulcer. Use moisturizer on your feet every day!!

Make "beating this" your top priority and we'll pray for you!

jCLNC · Oct 19, 2006

1.Your blood test should include an HBAIC (glycosylated hemoglobin) and go to an Opthalmoolgist to check your eyes for damage.
2.You need to see a good dietician and tell her to treat you like a grave digger and not like a nurse!! You'd be surprised the things we don't know
3.Join a Gym and if you need to - lose weight Grab a friend, spouse,or child and go walking every day
4.If you smoke -try quitting - it could save your life!!
5. Start taking good care of your feet- Never walk around barefoot, Always stick your hand in your shoe to make sure that it is free of stones or objects that you might not feel but can cause a serious ulcer. Use moisturizer on your feet every day!!
Make "beating this" your top priority and we'll pray for you!

I too have joined the ranks. My dad discovered his Type 2 Diabetes at the same age in his life that I have. I'm mirroring his progress, though I don't know that I ever heard him say that he lost the feeling in his feet.

My story is one of denial and as a nurse makes me a little ashamed...but I am also human. I go to the beach every year and take my family...don't go on vacation without them, Ha. But you know how the surface around the pool makes you want to dance it's so hot? Well, from one year to the next, I lost the ability to feel the hot. Still didn't do anything. About 2 or 3 years before that, I noticed the Plastic Wrap feel to the bottoms of my feet as I would get up in the mornings. My fastings were not bad at this time and my Internal Medicine MD is excellent. She was keeping an eye on me. So all told, I've really been a diabetic for about 8 or 9 years, only 3 with treatment. I wonder if I will ever get some of this feeling back in my feet. I've done a little research online, but nothing speaks to that point...it's just that part of it really bothers me.

I'm currently taking oral diabetic agents including amaryl, glucophage, and just started Byetta a month ago. My A1C was 7.4 last month. I know it needs to come down lower, but that was not even trying to adjust my diet...not that I am a constant splurger, but I don't go by the strict "3 pieces of bread a day...etc" diet.

Bad nurse! Not taking care of herself. I need a spanking. :nono:

I really think it's already affected my autonomic nervous system because I have gastroparesis, and I sweat a lot. My B/P is mildly elevated and controlled by diovan, and I frequently feel the pulse elevating "on it's on".

Scary. It seems that even when you do it "right" with DM, you lose. It's such an insidious disease.

A bad example for my patients,

jen

gitterbug · Nov 28, 2006

I was recently diagnosised NIDDM-II. did not have classic symptoms, only after vision exam did I really start all of the drinking/voiding thing. FBS was almost 600, this AM was 122. I have lost weight, removed many things from diet, walk every day, monitor skin with special attention to feet. I was not working when this happened, but I do plan on returning, if a facility wants me to work there , they must understand I need a little TLC too.

Good luck to everyone fighting this disease.

txspadequeenRN, BSN, RN · Nov 28, 2006

I am a type 2 diabetic but have always been controlled with diet. When I lost about 70 lbs last year I had no trouble at all with my BS. Now the 6th pregnancy I am having some issues. My doctor is freaking out because my fasting is in the 126 range and if I get above 95 in the morning all hell breaks loose. They put me on N- BID and wants me to take about 20 units of R a day. But I refuse the R because I already bottom out and they now think I may have gastricparesis . Truth is I feel horrible with everyone jacking with my sugars . I still work but find it hard to manage my glucose testing and eating while I am under the stress of work. I wish you luck..we are here for ya.

gitterbug · Nov 29, 2006

Queenie,

You are some woman. Diabetic and 6 pregnancies. Wow. I hope you get the sugar at a level you can tolerate and soon. Best of luck with the new little bundle of love. Keep us informed.

Nur_1996 · Dec 8, 2006

I agree we all need a little TLC. Take care of yourself queen, and you too gitterbug. I am also type 2 for two years, trying to keep my head up, currently out of work on sick leave, and trying desperatly to fight the depression. I enjoy reading the forums in allnurses.

gitterbug · Dec 9, 2006

Dear Nur 1996,

Thanks for the words of good will and cheer. Now, you know you are going to have dust yourself off, put one foot in front of the other, and start walking slowly back to better health and happiness. You will be in my prayers. Happy Holidays.

SCRN1 · Jan 22, 2007

I was just diagnosed two weeks ago with Type 2. The doctor started me off with Glucophage 1000 mg BID and Diovan 80 mg daily. My BP is fine, but the Diovan is supposed to protect my kidneys. My blood glucose has not come down (mid 200s fasting - almost 500) and was changed to Actoplus Met five days ago. Still no change.

My doctor said they are finding that by the time someone presents symptoms and is diagnosed with Diabetes, they have actually had it for about 7 years. I'm not sure how long my blood glucose has been elevated but I did check out of curiosity within the year and it was normal. I told my doctor this and from what I understood, he explained it could have just been because of fluctuation and I had checked it when it was lower, but the process of changes had already begun taking place.

No matter what I have tried eating and that I've been taking my meds as directed, I still cannot get it within normal range. I am to see the diabetic educator at my doctor's office this Friday and am hoping she will help me with figuring out what I should eat. I've been searching the net to see what I need...how many carbs/meal or day and such, but it is so hard to find anything cut & dry. Does anybody have any suggestions I could use until I see the educator?

I also work 3 12-hr night shifts per week. I'm finding that the nights I work are my better days as far as my blood sugar goes. But I can't work 7 nights/week. Also, I find it harder to work with my blood sugar elevated. I don't feel as focused as I used to and I get blurry vision. The nurses I work with are aware of my new diagnosis and they've been so helpful in checking behind me meds I draw up in syringes and if I'm really blurry, they'll start IVs for me if I need them to.

Myxel67 · Jan 26, 2007

I was just diagnosed two weeks ago with Type 2. The doctor started me off with Glucophage 1000 mg BID and Diovan 80 mg daily. My BP is fine, but the Diovan is supposed to protect my kidneys. My blood glucose has not come down (mid 200s fasting - almost 500) and was changed to Actoplus Met five days ago. Still no change.
My doctor said they are finding that by the time someone presents symptoms and is diagnosed with Diabetes, they have actually had it for about 7 years. I'm not sure how long my blood glucose has been elevated but I did check out of curiosity within the year and it was normal. I told my doctor this and from what I understood, he explained it could have just been because of fluctuation and I had checked it when it was lower, but the process of changes had already begun taking place.
No matter what I have tried eating and that I've been taking my meds as directed, I still cannot get it within normal range. I am to see the diabetic educator at my doctor's office this Friday and am hoping she will help me with figuring out what I should eat. I've been searching the net to see what I need...how many carbs/meal or day and such, but it is so hard to find anything cut & dry. Does anybody have any suggestions I could use until I see the educator?
I also work 3 12-hr night shifts per week. I'm finding that the nights I work are my better days as far as my blood sugar goes. But I can't work 7 nights/week. Also, I find it harder to work with my blood sugar elevated. I don't feel as focused as I used to and I get blurry vision. The nurses I work with are aware of my new diagnosis and they've been so helpful in checking behind me meds I draw up in syringes and if I'm really blurry, they'll start IVs for me if I need them to.

Find an aggressive endo quick! Oral diabetes meds won't touch the BG levels you have. You need insulin, and the sooner the better. Your Hemoglobin A1C could have been 12% or higher. The goal for good control is 6.5% or lower. PO meds can achieve only about a 2 point drop in the A1C. It takes insulin to get the kind of results you need. Your vision will improve when your BG control improves, so don't go out & get new glasses.

In annual checkups, usually only fasting BG is checked. 126 mg/dl is considered diabetes. A Hemoglobin A1C can tell you how good or bad BG control has been over past 2 to 3 months. Many people will have a good fasting BG, but cannot handle a large amount of carbs at one time. So FBG might be under 100, but if A1C is 6% or higher, this means after-meal BG levels have been high enough to push the A1C into the diabetic range.

Lifestyle changes are important, but without insulin, high BG levels can't usually be controlled. You need a combination of long, slow acting insulin (Lantus, Levemir, or NPH, plus rapid acting mealtime insulin (Novolog, Humalog, or Apidra). This does not necessarily mean that you will need insulin in the long term. Many people are able to switch to PO after good BG control is achieved. Your weight loss was due to your body's use of fat for energy since you were unable to use the carbs in your food for energy. Insulin resistance prevented effective use of your own insulin.

I am an RN and a Certified Diabetes Educator, and I work in a hospital based ADA accredited Diabetes Care Center . I also have type 2 diabetes. I hope that you will be able to find an endcrinologist who will be able to help you achieve good control sooner, rather than later. Most PCP's think they are capable of treating type 2 diabetes, but in my experience, they tend to undertreat and take much longer than necessary get good results. Make sure you go to a Board Certified endo.

Good luck with your education session on Friday. I would love to hear from you to see how you are doing.