My job requires me to be constantly moving around. When I get low, I do not have time to stop, test, eat glucose tabs, and wait. I usually overcompensate for fear of dropping too low again. Does anyone have any tricks of fixing a low when you are constantly moving and may drop low again? Thanks!
I think it has to do with priorities. Maybe I am just getting old and self centered, but if I my job had some really, really important thing to do, like go meet the president of the US and I was having a low, I would still test and treat. It has to do with priorities. Do you put your health and safety above your job?
ps. You can treat a low in two phases, first with glucose and second with protein (like beef jerky strips). The protein will convert slowly to glucose you over a couple of hours and buffer you somewhat against future lows.
I guess I would first ask what it is that you do? I agree with the two above responses that, to some degree, this has to do with priorities. I had developed a BAD habit a couple of years ago of putting D on the back-burner when at work. I ended up running high quite a bit, eating without taking insulin at work events, etc. No surprise my A1C was going up, despite the fact that, at home, I generally dealt with things appropriately. I kept making excuses - I was traveling A LOT for work, eating out a lot, working on busy projects, had important meetings I couldn't just walk out of.
When my A1C finally approached 10%, I had a serious conversation with myself (and my endo) and realized that things had to change. This meant that I had to go back on the pump and start dealing with D all the time, regardless of whether I was at work or anywhere else. This means that even if I'm in a very important meeting or situation, if I think I'm low or high, I have to step out, test, and treat accordingly. This means eating out only on occasion and planning ahead of time when I travel. I have discovered that even when a situation seems to be impossible of accommodating diabetes, there is usually some way to do so. Just takes a little creativity, planning, and confidence!
One last thing - diabetes is a covered disability under the Americans with Disabilities Act. This means that your employer must provide reasonable accommodations for you to do what you need to do to stay healthy. If he/she is not willing to accommodate you, then you may want to consider legal action.
I just got hired on at a new job. On the first day I was in my supervisor's office and was going to leave my stuff there (since I had no office yet), so took out my meter and tested before I left. I used the opportunity to let her know that I had Type 1 diabetes. She asked if I had ever needed to eat emergency sugar. (She asked as if this must be a really rare event!) I told her I carried glucose with me at all times and ate them as needed, and had not had a serious low in over ten years. I think it's a good ideal to tell supervisors or other co-workers as-needed so that they know what you are doing and don't think you're just taking a snack or texting your friends during work hours.
Working and diabetes can sometimes be tricky. I generally test regularly and try to head off lows before they happen (and also correct highs before they get too high). If lows are a regular problem and you are on a pump, you might use a lower basal rate on the days you are working. When I'm at work I always make sure I have a tube of glucose tablets in my pocket (I check each night to make sure it's full), and ideally I'd also have a meter with me, but I haven't figured out a way to carry my pump, meter, cell phone, and glucose tablets without making my pockets look ridiculously bulky (for a business environment).
Oh, did you get the job in Atlanta?? Congrats!!
It's not in Atlanta (??), but thanks! :)
I think a big part of it is always being prepared. As I've gotten older and lived with D for longer, I've gotten better at that. I always have a roll of sweetarts and my CGM receiver with me when I head into a meeting. I was walking into a meeting at work last week and someone who knows me well saw my sweetarts and said "Are you low?". Depending on the meeting, though, there have been times that I popped sweetarts based on my CGM without testing to avoid having to leave the meeting. I would not normally treat without testing in any other situation.
While I agree that you have to make your D top priority and I know that D is covered by the Americans with Disabilities Act, I also know that I need my employers health insurance benefits to be able to care for my D. I've also been around long enough to know that if an employer decides they want to get rid of someone for whatever reason, they can typically find a way to do it.
With that said, I always seem to find a way to take care of myself at work. I limit any restaurant meals and try to plan ahead. My meter sits on my desk along with sweetarts and I have cokes and juice stashed in my office. Most meetings I attend are such that I can step out to test and it's not a big deal.
I feel for the people with physically demanding jobs though. That's alot different than a desk job with meetings. When I do have work days that I'm on my feet and walking alot, I have experienced lows and ended up high from overcompensating. While you can stop and treat at work, it's hard to pay as much attention as if you were at home.
We'll see. I think if they let me keep my job with this-- which they likely won't-- I'll just have to pay absolute utmost attention to close management and probably run a little higher than I otherwise would. If I went uncontrollably low somewhere like Wrangell narrows at the controls of a large passenger ship-- it could be absolutely catastrophic. Would be on the front page of newspapers around the world... IE Costa Concordia... Obviously I can't allow that situation to become a real possibility, no matter how hard it is.. Doing some real soul searching to figure out if I am still the right man for my job with this-- that decision may not be left up to me to make though. I really hope, that even if I don't have the physical / mental guaranteed stability with this condition in order to do my job anymore, that they will let me have the dignity of making that decision on my own terms...
I agree with the others that it's not easy sometimes to balance work and diabetes care, but the D care has to come first. Bottom line from an employer's point of view is if you are low you aren't going to be terribly efficient at your job (whatever it is!). Yes, I agree with smileandnod that we can quote the ADA all we want but we know that if an employee is "too much trouble" and the employer wants to get rid of them they will find a way around it. None of us are so perfect that we don't have small infractions that can be documented and blown out of proportion. And in this job market, I think need for stability might trump need to defend our ADA rights.
This being said, I agree with those that said it's a matter of experience. In time we get to know the precise number of glucose tabs that will raise us up where we need to be. (Not foolproof, but usually anyway). And if we don't develop hypo unawareness and we feel a definite low we can just treat and not worry about testing first. (It took me awhile to do that!). Then there is that good old 21st century tradition: multi-tasking. Many people on here have said they can test as they walk, ride bikes, etc. (some say driving but I really, really, don't think that is a good idea!). How long does it take to test and then get glucose tabs and munch them even as you do other things? (assuming the tools are right where they should be in pocket, purse or on desk). A minute? Three minutes? And part of it can be done "on the go".
We are all allowed to go to the bathroom or get some water in our jobs, right? Does test/treat/test take longer than that? Hell, if there's pressure at work you can actually go to the bathroom! (Though many people would say ewwwww to that!). I've tested and eaten glucose tabs while on the phone. Or if there is a more sedentary part of your job such as doing something at a desk, you can always choose to do that for a bit before returning to more active and inter-active tasks.
I've taught only online since my diagnosis and that's a piece of cake. It's non-synchronous meaning there are no lectures in realtime. The only thing I have to watch is posting things when I'm low and not thinking too well! In Fall I will be teaching live again for the first time since diagnosis. I'm a little nervous about it but have already started planning how to do this and manage my D (namely lows). Actually reading this post has helped me too!
People do very demanding jobs with diabetes. In Canada, there are even commercial airline pilots with T1. There are only a couple of jobs that are currently closed to diabetics - fighter pilots and cross-country truckers.
I have not found any limits to working yet. Like others have said, I carry my CGM with me at work at all times along with glucose tablets. My meter/pump control is in my office or if I will be out of the office for an extended period or know I will be eating, I bring it with me. I'll test right in a meeting if I need to. Most of the time the CGM is enough security... if the line is flat, I know things aren't changing much an I am probably OK. If I am giving a presentation, the CGM should vibrate if I go slightly low and I'll pop a glucose tab and keep going.
I think it's really important to get the basal rates, I:C ratios, and correction factors tuned well so surprises (high or low) are minimized. If you see regular lows at a certain time of day , that should be a clue that something needs adjusting.
I reckon the key is catching the low before it gets too low and running blood sugars in as tight a range as possible. Easy said. Not so easy done.
Eating low carb (at least before and at work meals) would probably help the predicability of blood glucose. Protein and fat to help keep things steady.
Frequent testing to catch a downward trend before it goes far, and having some glucose / candy on hand (but not too much to go high). Know how much 1 glucose tab will raise you.
You probably know all this anyway. Hope you can find a way to work this out.