Diabetes and Shift Work
The key to diabetes is self-monitoring blood glucose levels. Always have your blood sugar monitor with you, particularly if you are away from home. Take your blood sugar a few times during your shift to see if you need to raise or lower your blood sugar levels. You will need to monitor your blood sugar most closely if you are switching to a new shift.
With day shifts, afternoon shifts, or midnight shifts, you still have to space your meals out. Diabetics should space meals out about four or five hours. Generally this is not hard to manage because most eight-hour shifts have a break in the middle. The difficulty might be remembering to eat just before your shift as well as during the break.
It is important with shift work, as with all areas of diabetes management, to always have your medication with you. You should also always have a snack or some juice with you in case your blood sugar gets low. Tell your supervisor about your diabetes so that you can take an extra ten minute break, or sit down for ten minutes to eat some fruit to raise your blood sugar. You will need to bring a planned snack for every shift in order to maintain your blood sugar. You should also have an extra snack in case your blood sugar drops unexpectedly. If, during the second half of your shift you begin to feel lightheaded because your blood sugar is low and you have already eaten the snack you brought, you will be in trouble. If you plan to bring a snack that you probably will not eat, you will be completely prepared.
It might be more difficult for a type 1 diabetic to work shifts than a type 2 diabetic, but both might have problems keeping an even blood sugar level because of the interrupted circadian rhythm. Your circadian rhythm is the cycle that your body goes through during the day to tell you when to eat and sleep. When it is disrupted by activities such as shift work, you need to be particularly cautious about your blood sugar levels.
If your job is particularly physical, you must also be aware of the effect of the physical activity on your blood sugar. You might need to adjust your eating habits accordingly. Physical activity means that sugar is absorbed by the body more quickly, and if not monitored, can result in hypoglycemia. If your job is less active, you might find less of a change in your blood sugar levels.
Track your blood sugar levels on a chart for a few days to understand how your blood sugar acts during the day. You will probably need to make changes to your diet and medicine for each of the different types of shifts you work. It is possibly to delay an insulin injection for an hour or two. However, before self-medicating, you should always talk to your doctor and dietitian to find the best plan that works for you. Even if you set up a plan before you begin shift work, you will often need to tweak it once you have been working and have established how your blood sugar is affected by the new schedule.
When you track your blood sugar level, try to plan to maintain a steady level. You dont want to have insulin levels too high when you are doing lots of physical labour. You will also want to reduce your insulin levels when you sleep. The change in sleep patterns is often the most challenging part of shift work, and this is doubly true for diabetics, because when you sleep you are not self-monitoring your blood glucose or adjusting your food and medication accordingly.
Once you have spoken to your doctor and dietitian about your shift-work and how to manage your diet, exercise, and medication, with self-monitoring and preparedness you will be set to go for the job!
Vivian Brennan is an expert on diabetes, and is currently an editor at The Guide to Diabetes (http://www.theguideto-diabetes.com/living_with_diabetes/) She is living with and managing her diabetes. She believes in educating people about diabetes to help manage diabetes, prevent complications, and improve lifestyles.
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