My son has IDDM and is having trouble adjusting to his work shifts with his pump. He works 3 months of days and then 3 months of nights, which is wreaking havoc on his blood sugar when he is on nights. He had to change doctors due to his insurance and unfortunately this doctor does not have many suggestions on what would be the best thing to do with his pump. Any tips or advice for my son?
Having type 1 diabetes, doing shift work and keeping blood glucose levels well controlled can be a challenge, but the pump should actually make this easier. It’s important for your son to make sure his insulin doses are correct. The pump delivers insulin in two ways, as a basal rate (a small set amount of insulin delivered every hour) and as a bolus dose (a larger amount given with meals or snacks). Bolus doses are determined by the mealtime blood glucose level and the amount of carbohydrate taken in at the meal. When people on a pump are having problems with their blood glucose levels , we usually have them first check their pump basal rates by doing a series of fasts. Once the basal rates are determined to be correct, we then check the bolus doses. To receive specific instructions on how to check both his basal and bolus doses, he will need to speak with a certified pump trainer. If he does not work with an educator, it would be a good idea to get one. If he has no access to a diabetes educator, he can call the pump company and ask to speak to their trainer. Many pump representatives are certified diabetes educators and are usually knowledgeable and helpful. It will take some work on his part to figure out the different patterns, but once he does, the pump can be programmed to deliver one pattern for work days and another pattern for non-work days and this should prove very helpful to him.