I will be returning to work next week after being diagnosed with Type 1 and the summer break and I am beginning to feel anxious about my return. Should Occupational Health be involved in creating a health plan for my return or can this be done in house with the head teacher. Can anyone tell me what happens if you have a hypo when teaching or if cgm alarm sounds for low glucose and a finger prick is needed? I know many people with Type 1 teach and that you will be able to offer practical support and advice.
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Primary Teacher Returning to Work
- Thread starter JenB
- Start date
Inka
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- Type 1
@JenB Occupational Health normally want a chat to make sure you’re ok, but my OH dept didn’t do a plan. I did ask for some reasonable adjustments but I asked the school for those (eg keeping my phone with me).
Re CGMs, set your Low alarm as high as you can so you have warning that you’re dropping and can ward off a hypo. Keep Dextro tablets on you, on your desk, etc, and take plenty of carby snacks that you can nibble if needed. TBH, I don’t bother to fingerprick if my Low alert sounds in class. I just eat. I have the Dexcom G7 which is brilliant.
If you have a TA in class, also talk to them about where your stuff is and when you might need a bit of support. Also, make sure everyone knows you have to bolus and that you can’t bolus then randomly be called to something because you’ll need to eat. Finally, never underestimate how little people know about Type 1. Many think they know all about it, but actually don’t and, worse, have misconceptions about it.
Re CGMs, set your Low alarm as high as you can so you have warning that you’re dropping and can ward off a hypo. Keep Dextro tablets on you, on your desk, etc, and take plenty of carby snacks that you can nibble if needed. TBH, I don’t bother to fingerprick if my Low alert sounds in class. I just eat. I have the Dexcom G7 which is brilliant.
If you have a TA in class, also talk to them about where your stuff is and when you might need a bit of support. Also, make sure everyone knows you have to bolus and that you can’t bolus then randomly be called to something because you’ll need to eat. Finally, never underestimate how little people know about Type 1. Many think they know all about it, but actually don’t and, worse, have misconceptions about it.
rebrascora
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Hi. Understandable that you will feel a bit anxious going back to work It can't harm to have a discussion with Occupational Health as you may require some "reasonable adjustments" to be made because as you say, you may need cover if you have a hypo during class. It is a long time since I was at primary school. Do you normally have a teaching assistant in class with you, who would be able to supervise for 10-15 mins if you had a hypo?
How is your diabetes management now. I believe you were only diagnosed in May so still early days for you. Have you experienced a real hypo yet and do you have a good system for dealing with them? ie Do you know the Rule of 15.... ie confirm with a finger prick if you are using a CGM unless you feel obviously hypo, have 15g of fast acting carbs like 4 glucose tablets or 3 jelly babies or a small carton of orange juice or whatever your chosen treatment is, wait 15 mins and retest with a finger prick (Do not rely on your CGM at this time as it will almost always show your levels dropping lower and likely cause you to panic and over treat. If your finger prick shows you are not above 4, then you have another 15g carbs and wait another 15 mins to retest. After you are above 4 you have the option to have another 10g of slower acting carbs like a small biscuit to stabilise things although personally I have never needed that and usually just 2 jelly babies is enough to treat a hypo, but better to be a bit high than drop low again.
I think it would be important to discuss with your head teacher whether they are comfortable for you to stay in class whilst testing and treating your hypo and also how you feel about that. For me, I can eat a couple of jelly babies and just carry on as normal and most people wouldn't know I was hypo unless it was a really bad one, but if you are not used to them, they can be pretty scary and make you feel really incapacitated. That said, with the benefit of CGM most hypos can be avoided these days by setting your low alarm a bit higher so you can head them off before they happen. I have my low alarm set at 4.5. If it goes off I know from experience that if the arrow is horizontal or sloping downwards, 1 jelly baby. will usually fix it. If it is a vertical downward arrow then I need 2 jelly babies. I am by no means suggesting this will work for you and you might be better setting your low alarm higher at 5.0, but having a plan for what to do when you alarm goes off and perhaps having a graded response depending upon what the arrow shows is quite helpful, so that you don't overreact but can fend off a hypo.
Good luck with it. Worth considering that you may be more active when you go back to work, running around after little ones, so you may find that you need to reduce doses a bit to counteract that.... depends how active you have been at home. It might be that the short term stress/worry of going back to work, pushes your levels up a bit. Unfortunately diabetes is quite individual and you just have to see what happens and then devise a plan to deal with it.
How is your diabetes management now. I believe you were only diagnosed in May so still early days for you. Have you experienced a real hypo yet and do you have a good system for dealing with them? ie Do you know the Rule of 15.... ie confirm with a finger prick if you are using a CGM unless you feel obviously hypo, have 15g of fast acting carbs like 4 glucose tablets or 3 jelly babies or a small carton of orange juice or whatever your chosen treatment is, wait 15 mins and retest with a finger prick (Do not rely on your CGM at this time as it will almost always show your levels dropping lower and likely cause you to panic and over treat. If your finger prick shows you are not above 4, then you have another 15g carbs and wait another 15 mins to retest. After you are above 4 you have the option to have another 10g of slower acting carbs like a small biscuit to stabilise things although personally I have never needed that and usually just 2 jelly babies is enough to treat a hypo, but better to be a bit high than drop low again.
I think it would be important to discuss with your head teacher whether they are comfortable for you to stay in class whilst testing and treating your hypo and also how you feel about that. For me, I can eat a couple of jelly babies and just carry on as normal and most people wouldn't know I was hypo unless it was a really bad one, but if you are not used to them, they can be pretty scary and make you feel really incapacitated. That said, with the benefit of CGM most hypos can be avoided these days by setting your low alarm a bit higher so you can head them off before they happen. I have my low alarm set at 4.5. If it goes off I know from experience that if the arrow is horizontal or sloping downwards, 1 jelly baby. will usually fix it. If it is a vertical downward arrow then I need 2 jelly babies. I am by no means suggesting this will work for you and you might be better setting your low alarm higher at 5.0, but having a plan for what to do when you alarm goes off and perhaps having a graded response depending upon what the arrow shows is quite helpful, so that you don't overreact but can fend off a hypo.
Good luck with it. Worth considering that you may be more active when you go back to work, running around after little ones, so you may find that you need to reduce doses a bit to counteract that.... depends how active you have been at home. It might be that the short term stress/worry of going back to work, pushes your levels up a bit. Unfortunately diabetes is quite individual and you just have to see what happens and then devise a plan to deal with it.
Inka
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- Relationship to Diabetes
- Type 1
@rebrascora The ideal is never to have a hypo in class. Setting the Libre alarm at 5.6 is what I’d do. My G7 is set at 5.5 but is far more accurate and also has additional alarms that alert me to falling blood sugar. Consequently, all I have to do is have some top up carbs if I think I need them. This is almost always at Break.
rebrascora
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The problem I had was if I set my alarm higher on the Libre, I didn't have any additional warning and since 5.6 is a perfectly healthy BG I would not want to be eating carbs at that level. I appreciate the Dexcom has a much better array or alarms so you get a second warning but with Libre I found that if I set my alarm even at 5 I had more hypos than setting it lower because I didn't always want to have any carbs at 5, so I would wait thinking I would keep an eye on things and then get distracted and perhaps end up 3.8 before I twigged I had dropped. I think each individual has to find what works best for them, but I think the Dexcom alarm system sounds a lot more practical than Libre in that respect.
Inka
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- Relationship to Diabetes
- Type 1
I wasn’t criticising your choice @rebrascora You do what’s right for you 🙂 My comment was on teaching. A teacher doesn’t want hypos and the way to avoid them is to set the Low alert higher, learn their normal blood sugar patterns, and keep topping up with carbs if needed. That way, I’ve never had a hypo in class. I know where my blood sugar should be eg 2hrs after breakfast, and if it’s lower than that then I nudge it back with a few grams of carbs. That’s all before it ever approaches a hypo level. I aim to have it going along at 5.6 to, say, 7.8 - ie ok but never dipping into hypo territory.
@JenB For your first few days back, I’d knock a bit off your breakfast bolus. That might mean you run a bit higher but it means you don’t have to worry and that you can observe patterns in your blood sugar.
@JenB For your first few days back, I’d knock a bit off your breakfast bolus. That might mean you run a bit higher but it means you don’t have to worry and that you can observe patterns in your blood sugar.
It is important you are comfortable, @jen.
In your position, I would certainly take advice from someone who is/has been in your position (another teacher) or someone who understands teaching (e.g. a teaching union rep).
My only experience of primary school teaching is being a pupil over 40 years ago. I wish you luck.
In your position, I would certainly take advice from someone who is/has been in your position (another teacher) or someone who understands teaching (e.g. a teaching union rep).
My only experience of primary school teaching is being a pupil over 40 years ago. I wish you luck.
