HI-HO, HI-HO, it's off to WORK, we go...

[CherylAnne]

Hi again!

I'm wondering what line of work you are in and how your blood sugar levels are affected by your daily duties...

Is it your habit, to carry your own lunch? What's in your care package?

What do you always have on hand as a quick pick-me-up?

Do you eat at the fast food joints? What foods do you eat there? What's your favorite, enemy food item, that cries out, eat me!...?

Can you explain your experiences with idle work compared to more physical work and how it affects your blood sugar levels?

Are there particular foods you eat, when you know ahead of time, that you will be working hard, exerting yourself?

Do you test your blood more often, during the day, according to what it is you are doing?

Okay, enough with the questions already! hehe

Here's the short and sweet on my diabetic mate, Bill; He works in the demolition/restoration business, basically construction. On a daily basis, he never knows whether he will be tearing down, putting up or swabbing the decks. He carries his own lunch. It's pretty standard, no frills; a breadfast sandwich-two eggs, two pieces of toast, lightly buttered with oleo spread. Leftovers, from the night before or a ham and cheese sandwich. For the quick pick-me-up, he takes a few oatmeal cookies and a couple of mini candy bars. Sometimes his care package includes snack crackers or cashews. His fast food joint of choice is Burger King, where he will order a Whopper, unless he's coming down from high sugar and he orders broiled chicken something or other.

There are days, when Bill doesn't eat all of his lunch stuff, he tells me he didn't work that hard, so he didn't need to eat everything. Ha, sometimes, I wonder if he's just telling me that, because he ate someting else instead. I have witnessed grown men tossing their lunch, just to please Mama with an empty dish...lol

Once, Bill packed cottage cheese and fruit cocktail for lunch. He said he would be working hard that day and needed the calories. (I think it was the calories)

For those inquiring minds, I own a sign shop...

I look forward to your input...

CherylAnne

[Gina]

hey Cheryl,

I carry my own lunch to work everyday which is usually a sandwich...some sort of fruit or maybe a small bag of chips...im on the insulin pump so i count my carbohydrates ...in my bag i always have glucose tablets with me in case i bottom out during the day they are easy to carry...also i have a small juice box and sometimes i just through in like a small bag of skittles or something like that it all depends....i dont want to have candy too close because i love it and to have it near me is a big tease.............my fav fast food joint has to be wendys when i go i usually get the chicken spicy sandwich and yes i eat all the fries ...thats why the pump is so good to have at your side hahah pump away....i cheat sometimes mostly on saturdays when i go out somewhere, usually at a bar and eat the pretzels which isnt sooo bad...everyone that is diabetic cheats you have to once in a while...all the time is no good but i have my moments hhahahah

[CherylAnne]

Hi Gina,

I'm not familure with 'the pump', so I am assuming that it monitors your blood sugar level and maintains it in a designated range.

You mentioned a couple of things I am curious about;

1) Counting carbs; from what I understand, diabetics need to eat a low carb diet. How many carbs can you have in a day? I suppose, the amount depends on a lot of things, male, female, large, small, active, inactive, etc...

2) Fruit; hmmmm, isn't fruit filled with natural sugar? I would have thought fruits would be a no-no... What fruits do you eat? Are there good fruits and bad fruits?

Thanks for your reply,

CherylAnne

[Gina]

Answers to your questions!!!

1. The insulin pump doesnt monitor your blood it only gives you insulin....how it works is just like long and short acting insulin all in one ...but with one type of insulin and thats humalog...you can only use a fast acting insulin in the pump....there is a basal rate which is your all day insulin (just like nph) over a 24 hour period of time you are getting a certain amount of insulin pumped into you each hour....then when you eat you bolus (just like a humalog shot) but you have to know exactly how many carbs you are eating to bolus for lets say i eat 45 carbs total at dinner...my insulin to carbohydrate ratio is 1 unit of insulin for every 15 carbohydrates...so i would take 3 units of insulin to cover me for that meal!! which gets me to your second question!!

2. Yes, you are right diabetics do have to eat a low carb diet....but, not too little because then you can have a high chance of getting a low blood sugar...right now things are easier for me because i am on the pump....I dont have to worry about lows as much as when i was on regular shots.....Diabetics that are on shots usually have 5-6 small meals a day to keep them at an ok level ....thats what i used to do when i was on shots...i would eat breakfast then midmorning snack then lunch then a midafternoon snack then dinner then before bed have a snack ...so my blood sugars would not go low....for me the most important snack was at night so i wouldnt bottom out in the middle of the night and sleep through it...the doctor or nutrionist you go to usually sets up a meal plan for you to follow to determine how many carbs you should be eating in a day....for me, i eat
15-30 carbs for breakfast
15-30 carbs for lunch
and 30-45 carbs at dinner i eat more at dinner so it will last the whole night....the more active you are the less insulin you will need during the day because exercising acts almost as like a medication because your burning sugar as you exercise...they say exercise for a diabetic is VERY important in regulating blood sugar control....

3. As for fruit, of course you can have fruit not like enormous consumptions of it but, yes you can have them...usually a cup of fruit adds up to about 15 carbs ....i usually eat those small apples and oranges you know like the real small ones....the bigger ones have more carbs as long as you eat moderately diabetics can have everything even candy and chocolate....one life saver is like 2 carbs which is like nothing....there are no bad fruits as long as you dont eat alot of fruit you will be fine....

i hope all this helps !!!!!!

Gina

[Mick]

Actually, all other things being equal, a type 1 diabetic can eat anything they want whenever they want, or nothing at all if they wish, and maintain stable blood sugar levels all day and night. I do not use a pump, I'm on the "MDI" routine--"Multiple Daily Injections". Most days I DO tend to eat the exact same thing at the exact same time, just because then I don't have to figure stuff out, count too closely, correct levels, or really worry much. I'm a school teacher, and when I teach I'm on my feet all the time, pacing, running about, writing on the board, never sitting much. I eat a bowl of puffed wheat (12 gr. carb), a sliced banana (26gr. carb) and a half cup of skim milk (7 gr. carb) for breakfast every day. the total amount is 45 grams of carbs, and since my ratio is one unit novolog for every 15 grams of carbs, I inject 3 units every weekday morning and know I will be perfect, neither high nor low. If I wake up with either a high or low number, I can add or subtract insulin to correct for that as well. If I really need a bagel, or a piece of toast, or some other item--for a change, or whatever, even waffles and maple syrup (yes, not a problem...), I add it all up and adjust for the total.

For lunch, I eat a carton of fat-free-sugar free yogurt and a salad. The yogurt is 15 gr. carbs, and although I don't measure the salad, I'm pretty good at getting a 2-cup, 40 gr. carb serving. If I want croutons, or they have something a bit more caloric at the salad bar that day, like garbonzo beans or dried fruits, I calculate and add for that--usually taking between 2.5 and 3.5 units at lunchtime.

Dinner varies night to night--my wife and I enjoy cooking, and we have a large collection of foods we enjoy. It's a bit more difficult to calculate dinner--many ingredients, seldom measured, but I DO add up the main starches and figure them. For instance, a helping of pasta or rice is 30-40 gr. carbs, a slice of bread is 15, etc., so I attempt to figure the number of servings--and figure my 1 unit per 15 grams. I do often figure high or low, but I'm seldom all that far off, and then will correct with either a snack if I'm low, or an extra small correction shot later if I'm high. IF i absolutely will not deny myself the double fudge brownies my son made, I look on the box, figure the carbs, shoot and eat. I do not do that very often, but when I do, I figure it in carefully.

Tonight, for example, I wanted to watch a movie and eat popcorn the whole time--an entire bag of microwave popcorn. It has 26 grams per serving, 2 servings per bag, 52 grams of carbs. I injected 3.5 units and enjoyed the whole bag. But generally, I seldom snack and I eat out at fast foods NEVER. If I do not wish to eat any particular meal, I just don't take any insulin. My glucose levels never change if I don't eat, because my basal dose--the background insulin (Lantus) that I take once a day, is carefully calculated to exactly maintain my blood sugar with no food or insulin added. This is called the "Basal/Bolus" routine--the basal is the long-acting dose which covers metabolic processes and should never be adjusted. The bolus is taken to cover any highs and whatever food is eaten.

The ONLY food that is any good for treating low blood sugars is glucose tablets or glucose gel tubes. Cookies and such contain fats, which slow down the absorption of the sugars and cause you to eat too much, thus overtreating most lows and beginning that yo-yo roller coaster ride. I still have the feeling that it's a ****ed shame to waste a low blood sugar on a yucky glucose tab when I could have one of those fudge brownies, but if you are truly low, the brownie will take too long to act. Plus, the glucose tabs aren't good, so you won't ever be tempted to take too many of them, and they contain an exact anount of glucose so you know exactly how many to take to raise your blood sugar an exact amount. I know that 4 of them contain 16 grams of glucose and that will raise me 50 points, each tab raising me about 12 points. The glucose gel tubes have 30 grams and will raise me 100 points in 10-20 minutes. I have these things--a tube and a bottle of tabs, with me at all times,and in my car, on my desk at work, on my dresser at home. I also keep an emergency glucagon kit at work, with the school nurse, and at home, in case I becose unconscious.

EVERY DIABETIC should have all this knowlegdge and information, and should also have all of these supplies and techniques in place. It's the only smart and safe way to live diabetic.

Michael
T1 since 1965

[Jon]

CherylAnne, diabetes is a very misunderstood condition. The biggest complaint I get about how I handle it with my son is when people find out that my son eats food with sugar in it. I had a real problem with his school principal last year. She asked him what he had for breakfast, and he told her Oreo Cookie cereal. I was immediately called in for a meeting with her. She told me that I was endangering his health, and that I should buy him an egg mcmuffin from McDonalds every morning like she does for her diabetic husband.

Type 1's need the carbs and sugar to keep the blood glucose from dropping too low with insulin.

Some type 2's on medication also need extra carbs occasionally to keep from dropping too low.

So the occasional fruit or candy is not a bad thing!

[statdeac]

Mick,

I'm on the MDI routine as well. I eat what I consider to be a "normal" diet, not a super low-carb diet. I bolus with Humalog whenever I eat anything, which my doctor refers to as a "low-tech" pump. The shots don't really bother me much using 31g. short needles.

I have looked at the pumps currently on the market and have decided to wait until the technology improves to automatically read and bolus like an atificial pancreas. Otherwise, I figure that I am really doing about the same amount of work and it's more expensive than my MDI routine.

Seems to be working for me. All of my A1c readings have been excellent (under 6.0) for the couple of years.