New technologies have opened up new job opportunities. Unfortunately, it has also changed regular working patterns. As working in shifts gets popular, more and more people are forced to readjust their body clocks to new sleep and wake-up routines.
Our bodies are influenced by internal ‘clocks’ called circadian rhythms. Among other functions, these clocks tell us when to sleep and when to be awake. Shift-work disrupts this balance and can result in mental and physical stress affecting blood glucose control. Stress affects the body by causing the release of hormones that lead to increased levels of glucose in the blood. This, in addition to different patterns of eating and changes in activity/ habits while working shifts, can result in unpredictable fluctuations in blood glucose control. It seems difficult for a diabetic to manage these fluctuations. This however, does not mean that diabetics cannot take up such a job profile.
Managing shift-work and diabetes requires careful planning especially if you are on insulin therapy. Here are some tips to help you manage the condition better:
Self-monitoring of blood glucose using a home device like glucometer is the most effective tool to determine patterns of blood glucose control and anticipate situations of high or low blood glucose levels.
- When changing shifts, monitor at various times to assess the blood glucose patterns while working.
- Record the results and respective situations in a record book, as it will help in making appropriate adjustments.
- Working shifts requires certain modifications or adjustments in insulin or diabetes pills (whichever one is using), exercise plan and meal pattern.
- Meal planning
Meal planning is the foundation of diabetes management irrespective of the type of diabetes or medication used. The basic guidelines include evenly spaced meals (four or five hour intervals) and snacks (if required), and consistent types and amounts of food.
- If working in the afternoon shift, include a larger evening snack to match increased physical activity, particularly if using insulin or diabetes pills.
- In case of midnight shift, eat more between 10 p.m. to 8 a.m. with an adequate amount of food for the periods of sleep during the day-especially for those on insulin or diabetes pills.
- Carry some snacks or sugar cubes at all times to treat hypoglycemia (low blood glucose).
- Physical activity Changes in the level of physical activity while working shifts can result in fluctuations in blood glucose. Regular exercise plans have to be modified depending upon the change in shifts.
- The best time to exercise is after a meal when blood glucose level tends to be higher.
- Moderate exercising after lunch is appropriate if working in an evening shift.
- When returning home from the midnight shift, exercising after the morning meal is preferable. This activity will help in relaxing and sleeping better.
* Please note: The above mentioned exercises should not be vigorous. Also, there should be a gap of about 30 minutes after a meal before exercising.
- In case one is using Insulin, consider the time when insulin starts to work and peaks.
- If one is taking diabetes pills, one should be aware of the time when the pill’s effect is at peak and also the length of time for which they remain effective.
Before making any adjustment in meal patterns, exercise or medications, do not forget to consult your doctor and dietician.