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March 12, 2002

Daily Care

Question from New York, New York, USA:

My fiance has had type 1 diabetes since the age of 15, and since diagnosis it has been very well managed, but he is now having difficulty. He works very longs hours, recently up to 100 hours per week, and we find it almost most impossible to keep his blood sugar down, even when he sticks to his usual diet and insulin regimen. I have noticed this effect every time he is going through this working pattern. Could the stress and extreme tiredness his job puts him under be having an effect on his blood sugar level? How we might be able to manage this?

Answer:

It would seem to me that your fiance needs a flexible insulin regimen (a basal/bolus program) or an insulin pump with a carbohydrate counting type of meal plan. I would suggest that you and your fiance visit with an experienced diabetes team to help devise a treatment plan that meets his lifestyle needs and optimizes control. If your fiance is not currently followed by such a team, he should ask his physician for a referral.

LD