Work with diabetes

[ILikeSugar :|]

Hi I've not long been diagnosed with type 1 diabetes and just recently got a job its only part time and i was just wondering how people work with type 1? Say if I have a shift at 5pm when I normally have my dinner should I have it earlier or wait till I'm finished at 9pm and eat something beforehand and also what if I was to be going on a low before work what would be the best thing to eat as I ended up getting paranoid and eating loads of sugar and chocolate so I ended up going high just so I didnt have a low? I get it for the most part but i just dont know how it would work if i was to work full time i always bring in a bag of sweets to be sure.

 

[helli]

There should be no problems working when you have Type 1 diabetes.
It is considered a disability so covered by the Disability Discrimination Act which means your employer must make reasonable adjustments. What this means varies depending upon what your job is. For me, it has just mean that I am able to take time off for hospital appointments although I always make up the time. For others, it may mean regular breaks, facilities for testing and injecting and, maybe different shift patterns.

In terms of when you should eat, as you are on a basal/bolus insulin regime and inject your bolus when you eat, you do not need to eat at specific times; you can eat at the same time sa you would if you were doing that job without diabetes.
If you are going low before starting work, treat the hypo as you would any other hypo. The only additional thing to consider is if you are driving to or for work or operating mechanical equipment. Then it is even more important to check that you have fully recovered from your hypo. It is usually advised to have a blood sugar level above 5mmol/l to drive and probably a good idea to aim for the same if you operate machinery.

A few things to consider
- always always always always keep hypo treatment close to hand.
- you may want to test your levels more often, especially if your job is physical as insulin works more efficiently when we exercise.
- in order that your employer and colleagues do not think you are slacking and to ensure they provide those "reasonable adjustments", it is a good idea to tell them that you have Type 1.

 

[ILikeSugar :|]

There should be no problems working when you have Type 1 diabetes.
It is considered a disability so covered by the Disability Discrimination Act which means your employer must make reasonable adjustments. What this means varies depending upon what your job is. For me, it has just mean that I am able to take time off for hospital appointments although I always make up the time. For others, it may mean regular breaks, facilities for testing and injecting and, maybe different shift patterns.

In terms of when you should eat, as you are on a basal/bolus insulin regime and inject your bolus when you eat, you do not need to eat at specific times; you can eat at the same time sa you would if you were doing that job without diabetes.
If you are going low before starting work, treat the hypo as you would any other hypo. The only additional thing to consider is if you are driving to or for work or operating mechanical equipment. Then it is even more important to check that you have fully recovered from your hypo. It is usually advised to have a blood sugar level above 5mmol/l to drive and probably a good idea to aim for the same if you operate machinery.

A few things to consider
- always always always always keep hypo treatment close to hand.
- you may want to test your levels more often, especially if your job is physical as insulin works more efficiently when we exercise.
- in order that your employer and colleagues do not think you are slacking and to ensure they provide those "reasonable adjustments", it is a good idea to tell them that you have Type 1.

Thanks @helli i only work in a supermarket and have told them about my diagnoses so all is good there but normally my sugar levels do go down fairly quick so if I was to leave on 5mmol I'd probably be going low maybe 1 or 2 hours later so many I need my long acting insulin lowered? Like if I go to work and my sugar levels are 9 I will come home a few hours later and then my levels will be around 6mmol which worries me about doing more hours just in case I go on a low.

 

[SB2015]

Welcome to the forum @ILikeSugar :|
I am glad that you have found us.

It sounds like you have already got your head round the basics, and your Diabetes Specialist Nurse will help you to learn how to make adjustments to your doses. The levels dropping when you go to work, could be simply because you are more active, and you are already thinking about making adjustments. I had different insulin doses for work days and for weekends because of the different levels of activity.

if your levels are dropping within two hours of a meal the other possibility is that it could be that you meal time dose is too high for the amount of carbs that you ate at that meal. Are you carb counting yet and adjusting your meal dose based on this info.

There should be no reason why you can’t work with T1. As @helli has said your work place may need to make adjustments for you, but the most important thing is to make sure you are able to test your glucose levels when you need to, and that you ALWAYS have a hypo treatment with you. I have a bag of jelly babies with me wherever I go, as well as stashes in the car, in each room at home, in each backpack, ….
At work I had them with me, as well as stashes strategically placed in various offices.

Be patient as it takes time to get things settled and doses adjusted to your needs, and I am still making changes to mine during the year. T1 keeps us on our toes.

 

[ILikeSugar :|]

Thank you @SB2015 yes I know just about how to manage my diabetes at the moment like you said it's just about making adjustments, i have actually been carb counting for a few months now but it seems to change quite a lot sometimes I'll be taking 1 unit per 10g of carbs and then other times I'll be taking more or less then the amount needed so it can be confusing at times.

 

[SB2015]

There are so many factors that a working pancreas deals with, and we are doing that job now.
So it is not surprising that we find things change regularly.

Keep monitoring, keep adjusting and keep asking any questions that arise.

 

[helli]

i have actually been carb counting for a few months now but it seems to change quite a lot sometimes I'll be taking 1 unit per 10g of carbs and then other times I'll be taking more or less then the amount needed so it can be confusing at times.

It may be useful to keep a diary - not in a teenage girl type of diary - and include things which may affect insulin sensitivity/resistance.
For example, some of us find we are more insulin resistant in the morning so have a different ratio for breakfast, exercise can reduce our insulin needs for up to 48 hours afterwards, stress will increase our insulin needs, ...
A diary of food eaten, activities undertaken and blood sugar levels can help spot patterns to identify changes that you can make.

We can help and we can highlights which affect levels of some/most people but a common thread amongst diabetics is that we are all different so we need to learn what works for us.
And be prepared for it to change.

 

[ILikeSugar :|]

There are so many factors that a working pancreas deals with, and we are doing that job now.
So it is not surprising that we find things change regularly.

Keep monitoring, keep adjusting and keep asking any questions that arise.

Thank you for the advice I will make sure to do so

 

[ILikeSugar :|]

It may be useful to keep a diary - not in a teenage girl type of diary - and include things which may affect insulin sensitivity/resistance.
For example, some of us find we are more insulin resistant in the morning so have a different ratio for breakfast, exercise can reduce our insulin needs for up to 48 hours afterwards, stress will increase our insulin needs, ...
A diary of food eaten, activities undertaken and blood sugar levels can help spot patterns to identify changes that you can make.

We can help and we can highlights which affect levels of some/most people but a common thread amongst diabetics is that we are all different so we need to learn what works for us.
And be prepared for it to change.

Thank you @helli I will give it some thought and maybe that will give me a better idea of what to do in certain situations ever since I've come out of hospital I've kept records of what my sugar levels have been before a meal so that would seem like a good idea.

 

[everydayupsanddowns]

Sounds like you are doing great @ILikeSugar :|

And the analytical approach you are showing here - identifying times when you might be at risk of going low, and trying to take precautionary action - will stand you in good stead for your new career as a pancreas impersonator. 😛

If your work role is physical, and uses more energy/glucose it might be worth treating it like you would if you were exercising like jogging - with possibly a combination of reducing the insulin dose in the preceding meal, and/or topping up with small quantities of fast acting carbs intermittently. Perhaps a single jelly baby, or a biscuit every so often.

It might take a bit of experimentation to work out the details that generally work for you, and long-term this sort of fine tuning is much easier if you can get access to a continuous monitor like Libre2 so that you can check whenever you want, and get notified if your BG has reached certain points.

Thinking about your basal is a really good call too. If you were working full time, you’d probably find it would need adjusting downwards. Depending on your shift pattern, it might be helpful to have a responsive basal insulin like Levemir, eg so that you could adjust the morning basal dose downwards to have less basal active when you were working that day, but have more active on non-work days.

Let us know how you get on 🙂

 

[ILikeSugar :|]

Sounds like you are doing great @ILikeSugar :|

And the analytical approach you are showing here - identifying times when you might be at risk of going low, and trying to take precautionary action - will stand you in good stead for your new career as a pancreas impersonator. 😛

If your work role is physical, and uses more energy/glucose it might be worth treating it like you would if you were exercising like jogging - with possibly a combination of reducing the insulin dose in the preceding meal, and/or topping up with small quantities of fast acting carbs intermittently. Perhaps a single jelly baby, or a biscuit every so often.

It might take a bit of experimentation to work out the details that generally work for you, and long-term this sort of fine tuning is much easier if you can get access to a continuous monitor like Libre2 so that you can check whenever you want, and get notified if your BG has reached certain points.

Thinking about your basal is a really good call too. If you were working full time, you’d probably find it would need adjusting downwards. Depending on your shift pattern, it might be helpful to have a responsive basal insulin like Levemir, eg so that you could adjust the morning basal dose downwards to have less basal active when you were working that day, but have more active on non-work days.

Let us know how you get on 🙂

Thank you I like to do my research as I've heard a lot of people cant work with diabetes so I want to do all i can to live a "semi" normal lifestyle my role at work is self check outside so it's a lot of standing but not much movement so I dont think that should count as exercise? And luckily I do have a libre 2 which has helped me millions I dont think I'd be managing it as well as I do without it so luckily they put me on it early and I normally check just before going to see if my sugar levels are good and always bring a bag of jelly babies in with me, thank you for the advice and I will let you know how it goes in the coming weeks @everydayupsanddowns

 

[everydayupsanddowns]

Thank you I like to do my research as I've heard a lot of people cant work with diabetes so I want to do all i can to live a "semi" normal lifestyle

I’m not sure where you’ve heard that from, but it is absolutely not my experience at all. I was diagnosed at 21, so my whole working life has been with T1 diabetes - both working for small and medium-sized companies, and running my own business. Including working under lots of pressure and stress, late nights, work travel, presentations, working on my own, and in teams.

Some things have involved a little more preparation and taking some precautions - but diabetes has never stopped me doing anything I wanted to in my work life. 🙂

 

[ILikeSugar :|]

I’m not sure where you’ve heard that from, but it is absolutely not my experience at all. I was diagnosed at 21, so my whole working life has been with T1 diabetes - both working for small and medium-sized companies, and running my own business. Including working under lots of pressure and stress, late nights, work travel, presentations, working on my own, and in teams.

Some things have involved a little more preparation and taking some precautions - but diabetes has never stopped me doing anything I wanted to in my work life. 🙂

I heard it a while ago from a doctor when I was in hospital but I'm glad to hear otherwise and happy to hear you've done well with it, I'm probably over thinking it but better safe then sorry I guess I'm sure all will be fine it's still early days 🙂 @everydayupsanddowns