Paul – how to solve problems

Pauls problems are that when he finishes football his blood glucose is always higher and he is very hungry. He has a small snack with no insulin. By the time he gets to the pub and has food his blood glucose is even higher, so he takes his normal (and sometimes extra if he is very high) fast-acting insulin with food. He drinks pints of lager and often the amount varies. He has noticed he sometimes has night hypos and he is often low at breakfast. What he could try:

1. Before – He could try and have a slightly later lunch at 2.00, or a snack around 3.00 with fast-acting insulin (This would give him insulin working when he is exercising and stop him from going high. It might also stop him from being so hungry at the finish).

2. After – If he does continue to have a snack at the end of the game, he could take 70% of his usual dose to cover the food he is eating (This will stop him from going so high before his food and drink).

3. After – After exercise he should reduce his following meal fast-acting insulin dose, so he could try reducing it by 70-80% (To prevent hypos in the evening/night).

4. Bed – If he is drinking alcohol, and he has exercised in the evening he should have a carb snack at bed with no fast-acting insulin before bed (To stop night/breaklfast) hypos.

5. The following day he might need to reduce his fast-acting breakfast dose as he has been drinking alcohol the night before (see alcohol section).

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