University Toolkit: New routines

It’s very likely that you may have a very different routine when you are at university. Watch out for things that may affect your blood glucose level such as changing your physical activities, different types of food, different daily schedules and participating in social events (planned or unplanned). Walking long distances around campus and cycling are also physical activities and may cause hypos. It may take a little while for you to get your Carb estimation right with new types of food.

Tips:

• Carry your diabetes pack with you all time (both quick and long acting insulin pen, blood glucose and ketone testing meters and strip, hypokits and snacks)
• Frequent glucose testing will help you identify whether your insulin dose adjustment is correct
• Cut down your quick insulin if you are going to be very busy walking, or have planned increased physical activity
• Never stop you background insulin whether you eat or not
• You may need to consider different amounts of insulin for physically active days and resting days; you may need less insulin during busy weekdays and less at weekends if you are less active. Try a small changes (e.g. 10% up or down). Please speak to your healthcare team before making any insulin regime changes
• If you have unplanned physical activities but you have already had your insulin, try to eat some snacks
• If you are not sure what to do, call your diabetes team for help

If you find your glucose has been very up and down from hypo to very high, please consider the following:

• Make sure you change your needle with every injection
• Ensure you are rotating your injection sites to avoid getting fatty lumps
• You may have a high reading following hypos – generally you shouldn’t correct a high if it’s only a few hours after a hypo. If you haven’t over treated your hypo, usually your blood sugar will drop again by itself
• Think of why you have hypos first:
  • Is it exercise related? If so, cut down your insulin before exercise. You may also need to eat some snacks (see the Exercise section)
  • Is it related to a long gap in between meals? If so, think of adjusting your background insulin dose down
  • Have you miscalculated the amount of your carb?
  • Do you need to change your insulin to carb ratio?
  • Have you corrected a high glucose reading with too much insulin?
  • Did you have alcohol the night before?

If you have a particularly high reading please check whether:

• You have any other illness such as flu or stomach bugs? If so, follow sick day advice
• You underestimated your carb? Pasta, rice, pizza are usually underestimated
• You failed to give insulin for your snacks? If you routinely have snacks in between meals but keep forgetting to inject insulin, consider having extra amount of insulin (calculated for your snack) with your main meal earlier
• Your glucose is higher on prolong fasting? Then, you may need to increase your background insulin (or basal insulin for pump user)
• Your carb ratio is correct? Check with glucose testing before and 4 -5 hours after the meal to check whether your glucose level was stable. Try with Carb that are easy to quantify i.e. you know exact (e.g. measured cereal)

If you are still having issues, please contact your diabetes team for support and they may also need to check on you to make sure you have no other illnesses that are causing your glucose levels to fluctuate.