Hello everyone my name is doug I like to think I take good care of my diabetes my a1c is 7.3 and I check 6 times a day. I need to excersize more, but what is stopping me is the fact that I work 40 hours a week. I have not come to grip with how to manage my diabetes and also work. If it gives you a better understanding I work in a business setting so things go off of numbers, how long we are at our desk, and how long we might be on a call and etc… so I find myself going low and high randomly through out the day and it’s causing me to not be as successful at my job as I should be which in turn makes my bosses question if I can “perform the essential functions of the job”. I don’t want to get fired due to complications. How do you guys overcome this struggle when it comes to working and being a type 1 diabetic.
you can’t get fired for complications, there is the ADA and other laws prohibiting companies from discrimination on the basis you have diabetes.
low and high randomly is a very big issue. figure out if it is your basal or long acting insulin, or if you are having trouble with mealtime bolus (or shot). if you are on 70/30 or NPH it may be time to look at your strategy. Even if you are on long acting basal insulin and fast acting at meal time… it’s still a possibility you could change your strategy and improve. if you pump, again and finally, it may be time for a pump setting tune up. in all cases, please consider getting the book “Think like a pancreas” because it explains all of this.
you heard the theory of “sharpen the saw”? or how about the quote “…When you do not have your health, nothing else matters at all”. there’s a lot of truth in there. prioritize and figure out what you want right now and what you want 10 years from now. In between: plan and stick to your plan. I work full time too, sometimes downright crazy activity at work - my point is if I can do it then others can too.
I get it I have suffered from burnout and depression, It can seem overwhelming, and like you’ll never have the ability to do it all, but many times it is fear/anger/denial that is keeping us from our personal best, not diabetes. Click here for more information from @BillHavins on the subject.
Hi doug @re-silient, it ain’t easy but it can be done. As @Joe says you may need to look closely at your insulin [type and timing] and how it works with YOUR body and your activity and meal timing. The pre-mix insulins such as the 70/30 and 50/50 can never work for me because my body needs only about 30% of my total daily insulin as basal or background insulin. It took me [and doctors] a long time to figure this out - about 30 years - but since I grasped this diabetes management has been mostly for the last 30+ years.
Step back a bit and look at your daily schedules and see if you can find a pattern - KEEP NOTES - and then time insulin and meals. I know the demands of work and how things change from day-to-day - I worked 50+ hours a week while working for more than 50 years and fit in years of night school - but YOU can do it. What helped me some was avoiding “low BG” as much as possible but not letting me go so high that I got groggy.
Hi Doug @re-silient. Diabetes is a challenge but, as Dennis says, it can be successfully managed. Dennis is right, keep notes, log your BGs, your carbs (and if you eat high fat meals such as pizza) and what you are doing throughout the day. It can be a lot of work but this information is what is needed to help you sort things out. I’d also see if you can get help from your doctor, or have your doctor refer you to a Certified Diabetes Educator (CDE). While a doctor will spend 15 - 20 minutes with you, CDEs can spend more time with you and help you with figuring things out and putting a plan together to work towards making things more stable.
It’s all about “timing.” And if you’ve had T1D long enough, what I include below will make sense to you.
If you want to be able to “perform” every day, then you have to ensure three things happen. First, you have to know what your insulin is doing, so you have to check your BG at the same times during the day, as well as when you think your BG requires attention.
Second, you have to ensure that you receive the same amounts of insulin at the same times every day, and that the amounts are appropriate to your needs for the day.
Third, you have to eat the same amounts of carbs at breakfast and lunch each day, and that you have those meals at the same time each day. You also need to ensure that the snacks you eat during the day are appropriate to your BG readings.
We’re not talking about huge amounts of time for these tasks - likely no more time than other employees spend shooting the breeze.
Here’s how it works for me. I eat breakfast and lunch at the same time every day; I infuse an insulin bolus with each meal.
I check my BG when I get up and at Noon. I also check my BG at 11:00 a.m. and at 3:30 p.m. I make those checks because those are the times on workdays when I may begin to run low. If my BG is low at either of those times I eat a snack that is adequate to raise my BG and hold me until my next scheduled meal.
I have timers set on my Apple Watch to remind me of the 11:00 and 3:30 BG checks. I also have a timer set to remind me to end what I’m doing and go to lunch. If I’m involved with someone when my timer goes off I explain that I have a “scheduled task I must do,” and I’ll ask if I can get back to them in three minutes (for the BG check/snack) or twenty minutes (for lunch). Most people are very understanding and will either wait for me to get back to them, or they’ll offer another time for us to continue the conversation.
That’s the shorthand version of how I do it. I bet you can get something to work for you, too.
I would suggest CGM if you can. I was having the same issues at work and home. I’ve lived with it for 39 years and the biggest two things that changed my way of life was an insulin pump and CGM. The CGM actually helped my drop my A1C by one point. It has also helped me at work as I can see when I’m slipping into a low area as well to high that may cause me to be agitated with my employees. I agree with Bill in the post before. I eat in a very similar pattern and very low carbs. We are here to help.
I worked in Big 5 consulting and you are right to be concerned about what your bosses are thinking, their is built-in bias regardless of how hard we try to eliminate. Today’s highly tracked and monitored work environments are especially difficult if you are in a call center. I would recommend getting on a pump and a CGM. I have used most on the market and currently use the Abbott Libre, mostly because my insurance doesn’t cover a CGM and it has the most reasonable cash price. Abbott has just come back into the market in US, so they have a promo to get started. In the meantime, keep your carb intake consistant, and reduce it before sitting at a desk for long periods. Carb counting is best way to dose insulin, whether from a pump or injection.
I’ve had T1D for over 20 years now. It started when I was an adult in mid-career. It was awful dealing with the highs and lows on the shots. I am very grateful that my endocrinologist switched me within a year or two onto an insulin pump, which allows much finer regulation of insulin, basal and bolus. Still had to test sometimes up to 12 times a day, but I got it in better control.
More recently, in just the past few years, I have had a continuous glucose monitor, which has been a Godsend. It has kept me safe during lows by alerting to wake me up in the middle of the night and to warn me in advance when my sugar was falling or rising too fast, needing immediate attention. I strongly recommend an insulin pump (they typically use just faster acting insulins) and a CGM sensor (measuring blood sugar levels every 5 minutes 24/7 without you needing to do a finger stick) if you are brittle and need to put your diabetes management into the background instead of the foreground. I still test whenever I am unsure if the sensor is correct and to calibrate, but I have freed up a lot of my own bandwidth to manage it better. Have been able to keep my HbA1c below 7 most of the time. Once when I was hospitalized for a different problem, they took me off the pump and sent me back into extreme highs and lows with the shots. It is very convincing to experience the smoother management once you get a pump and a CGM sensor/monitor.