Being a nurse and managing eating

Hi everyone! Just joined here and recently was officially diagnosed as a type 2 diabetic. I am a nurse who works 3-11 and I not only struggle with either always feeling hungry and or not eating enough, My biggest problem is eating stuff that is easy to eat thats healthy but fills me up and or doesnt drop my blood sugar (if i only eat say salad i burn it so quickly my bs drops too much). Lately I have been eating a snack when I get home at midnight even if i have time to eat something say when i am documenting an hr before that. If I dont I lay awake starving even though I ate something not so long ago. I have a few dietary restrictions due to allergies like I dont eat beef, pork or eggs so my protein is limited. I am in need of support especially was wondering if anyone else struggles with these things. Everytime I have reached out on something similar to this I get beaten down by someone that says “youre a nurse you should know better” I cannot control the main reason why I was diagnosed but my eating and weight gain just made it happen sooner so thats what I need to get a grip on all this.It also doesnt help that I am extremely tired all the time and yes I have been tested for sleep apnea and that was negative so I have no energy. Anyone have any suggestions? I have refused meds so far and my AIC is 6.9. It is on the up trend so they want to stop it early but every MD i go to puts me on a med with terrible side effects or I go to a dietician that gives me paperwork and makes me do it all myself…if I could do it myself would I be struggling?? Alot of babbles but I hope to just find people to chat with and maybe get some snack ideas and how to manage hunger. And yes exercise (from a former “athlete” turned overweight lazy girl) scares me and for some reason makes me more exhausted! Thanks everyone and hope everyone is well!

If you have Type 2 diabetes, your BG is still high, and you cannot tolerate any oral meds due to side effects, you should be on insulin.

I’m confused; it makes absolutely no sense when you say that you become hypoglycemic after eating a salad. While very low in carbs, a salad contains some carbs. In the absence of any medication that lowers your BG, eating a low-carb meal wouldn’t lower your BG… When you say that your BG “drops too much”, what number does it drop down to? (Are you using a meter?)

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I would recommend just getting creative with snacks. I love cheese. It can be very low carb but high in fat and protein which is very satiating. I also love fish. Seafood all over the place. I carry little cans of seafood wherever I go and they are very convenient. Cans of sardines, herring, mackeral and tuna. They even make little pouches of flavored tuna.

Just some ideas.

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that’s not going to happen here.

here are some other low carb ideas

Sorry you’re having so many problems!

For your salads, are you putting a good deal of protein on them such as chopped up chicken, turkey or maybe tuna? I like to buy the frozen pre-cooked chicken breast strips for making salads with as that makes it quick and simple, or cook a batch of chicken breasts and chop them all up and put them into a container to use for a few days. Turkey you can do easily by going to your deli and asking them to slice off a thick chunk of low-sodium turkey breast at their highest setting on the slicer (usually about 1/2" thick) and then cubing that up.

Turkey pepperoni can also be a tasty addition to a salad or a yummy snack if you don’t have any problems with any of the additives in it. Along those lines, turkey-jerky or salmon-jerky are also good snacks that are good sources of protein.

Cottage cheese, if you like it and can tolerate it allergy wise, is also fairly filling and can be a good source of protein. It’s a great snack with some lower-glycemic fruit like berries.

It sounds, though, like you may need some carbohydrate if you’re worried about your blood sugar dropping. The question becomes how much. The problem is that only you can figure that out by “eating to your meter.”

Second the motion. Viewing insulin as a “last resort” is one of the most pernicious things about the way we approach diabetes today. It’s simply a tool. If it’s the best tool for the job, then you use it. If you can’t achieve adequate control in other ways because of food allergies, medicine side effects, or whatever, then you attack the problem with the weapon that can fix it. 6.9 is just too high.

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Being a nurse, you are always on the run, so exercise itself likely isn’t an issue. Your lows when eating a salad are more likely due to the exercise in your job coupled with no carbs. Protein will help stabilize your BS values. Try beans and nuts, or cheese as others have suggested. I buy a bean + coconut + dried cherry snack mix at Costco, and it provides me with both protein and some carbs. Find something like that which you like.

I third the recommendation of insulin to fight the high BS - 6.9 says you are having highs, and lows at night are likely making you tired. I recommend looking into Afrezza inhaled insulin for a Type 2. It is easy, and dosing as needed is quick and convenient in a job like yours.

My understanding after reading the OP’s post is that she is currently taking no glucose-lowering medication or insulin. If this is indeed the case, I do not understand how exercise alone (without glucose-lowering meds) can result in a clinically low BG level after eating a meal containing carbs (however few).

And I echo David’s comment that an A1c of 6.9 is just too high. I personally wouldn’t continue not taking meds with an A1c of 6.9 and I wouldn’t recommend that anyone do this…

I suggest making a bowl of salmon salad or sardine spread every few days. Put it into small tupperware containers & take to work. Great quick protein. I keep a ziploc of Wasa multigrain flatbreads at my job. These are complex carbs, high fiber. 1 of these with some fish or cheese is a perfect D snack or light meal.

In emerging diabetes you can lose your phase 1 insulin response. When you eat a carby meal your body respond with only your phase 2 response which is sluggish. By the time your poor pooped out pancreas starts producing insulin your blood sugar is high and your pancreas goes into overdrive. Then when your blood sugar finally does come down your body is sluggish in ramping down on the insulin and you can have a hypo. This is called reactive hypoglycemia and is not uncommon in those with emerging diabetes. I observed this myself years ago when I found that if I exercised after a meal containing some amount of carbs (not even a lot) I could have lows down into the 50s.

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Thank you for explaining this, Brian! I learn something new every day; another reason I love this Forum!

And then the really cruddy part is to “fix” it you eat more carbs, usually too many and go high, and end up in a cycle of lather, rinse, repeat for awhile sometimes.

I’ve found, at times, with careful observation of my CGM and use of my insulin pump, I can temporarily decrease my basal rate to “take away” insulin from a trending low that is repeating a recent pattern. I can also cancel a pending extended bolus that’s currently active.

Another technique that doesn’t add calories or sling-shot us into the gluco-coaster is using “mini-gluc” shots. This is impractical given today’s expensive glucagon kits do not have long shelf life once the powder is mixed with the saline. I have taken 15-20 units of glucagon as measured in an insulin syringe to effectively turn around a trending low.

I’m hoping that the various artificial pancreas projects will give rise to a shelf stable glucagon solution that we can utilize to treat lows without adding calories and pushing us into the glucose roller-coaster.

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A worthwhile goal indeed.

+1

I am a retired nurse,worked 3-11 for years before D. In saying this make a visit with the diatetien as she may have some good suggestions to meet your allergy and diabetic needs. Remember we may know many things but in this role we are the patient. Getting support is very helpful. Nancy

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thanks for this list its very helpful :slight_smile:

thanks Nancy! Yeah i tell ya its the hardest shift to maintain eating. I went to a dietician a couple of times (2nd one I have tried) and they just give me a folder and say here try these ideas. If I was able to do it on my own I wouldnt be struggling. I wanted or was hoping someone would take a list of food I eat or will eat and map it out for me of what and when i should eat because I have tried and I get bored and fail in 3 days but people have told me this is impossible to find because every diabetic is different. Apparently we are all supposed to become statistics who take too many drugs. Thanks for the encouraging words!

good idea thanks!

thanks. my MD told me I wasnt in the range of needing insulin none of my numbers necessarily indicate that I need it. I would never take insulin for a premeal sugar of 140 because I know especially if i am at work I wont eat a full meal and bad things will happen. My struggles are balancing the food. I know 6.9 isnt as bad as it could be and I can reverse it or make it better with diet I just for some reason cant get past the when to eat with my schedule and what so its not terrible for me but also to not gravitate towards crap food thats bad just to eat something. I know I can do it I just feel alone in the doing. Is the beans in this snack mix like a soybean or something? And is Costco like a walmart haha I dont know if I have one of those here in mass but I am sure I can find something similar

Also, my diabetes development was caused by having PCOS which when told I had that 15 years ago I didnt worry because they said the meds I was on slows it down didnt think it caused diabetes and I work in geriatrics and didnt really study that stuff so I never looked it up or asked. Never bothered me till now when I gained 70 lbs and have a mother with type 2 (diagnosd the same week as me). I have to say if I had known this I just may have been a bit more cautious but that is the past now I am trying to fix my future