Sarah Howard
Sarah Howard has worked in the diabetes research field ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange.
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If you’re an adult with T1D, have you worked at a job that requires strenuous physical activity (ex: construction, landscaping, etc.)? Share your experiences and advice for managing T1D on the job in the comments! Cancel reply
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While I have not worked in construction in the typical sense, I have worked in set construction for the stage, as well as at a “big box” home center, which can both be strenuous at times. In stage work, I was usually fine, only needed to take a break occasionally to treat a low BG. In the “Big Box” store, I had more difficulty controlling my BG due to the unpredictability of the business – – heavy lifting one day and very little the next – – and the constantly changing schedules. I finally had to go on a “set schedule” to get them under control.
I’ve been a zookeeper for the last 7 years. At first it was wonderful. The exercise meant I needed less insulin and all the fresh air felt great. Plus animals everywhere. Over the years it’s been getting harder. First my anxiety levels increased because it was difficult for me to get back to our office/break room to wash my hands and check my blood sugar if I felt like it was going low. I was nervous about working with dangerous animals with my blood sugar low, so I adopted a “better safe than sorry” approach and would snack if I felt even a little bit hungry. Often my blood sugar would turn out to be high by lunch or dinner and I would have to guess, based on how much I’d eaten in between meals, whether or not I’d been right about the low blood sugar. I don’t think my doctor believed me about the lows because she was seeing a bunch of highs. She kept telling me to take more insulin. I eventually got a CGM and discovered that, on average, I was having 45 low blood glucose events every month. Like PamK said, the variability in my workload day-to-day made predicting insulin needs challenging. I tried the Omnipod dash for about a year but found it to be extremely painful, especially when worn on my stomach. It would pinch and poke whenever I had to bend or squat or lift anything heavy – which is quite often when you’re working in a barn. In the last couple of years our new curator has implemented a split shift schedule, but instead of hiring more staff to work the 2nd shift she just split us in half. Sometimes I’m on the early shift, sometimes I’m on the late shift. It changes every few days. And either way my workload increases dramatically because there aren’t enough of us available during the busiest times of our workday (first thing in the morning and in the evening before it gets dark). The constantly changing schedule makes it really difficult for me to identify patterns in my blood sugar. I’ve been diabetic for 28 years. I used to be very comfortable changing my ratios or long acting dose when I noticed patterns of high or low blood sugars, but in the last few years I’ve lost almost all of that confidence because I just can’t keep track of all the variable anymore. I don’t think I can ask for accommodations because a) our head of HR is horrible and I think asking for accommodations would create a hostile work environment for me and b) I’m pretty sure they would say my accommodations are unreasonable because we don’t have enough staff to accommodate me. I love my job but I don’t like going to work anymore because I feel sick and overwhelmed more often than not. I’ve started looking for new opportunities even though it will break my heart to leave my favorite animals because I can’t take adequate care of them if I’m not in good health myself.
I forgot about the advice part… Keep snacks on hand that you can eat quickly and on the go. I like fun size skittles packets. I can tear open the pouch and dump the skittle into my mouth without having to touch the skittles with my dirty hands. I also keep a larabar (or similar energy bar), a roll of glucose tablets, and a packet of almonds. All can be eaten without touching the food, just the wrapper/container. Peanuts work, too, but will get “sweaty” in the summer and other kinds of candy, like dummies, will either melt or freeze weather depending.
My CGM has helped a lot with my anxiety, but if you can keep your glucose test kit nearby and easily wash your hands, there’s no reason that you couldn’t stick with a blood glucose meter if that’s more your speed. Anyway, I set my alarm to 85 so it works a little like an early warning system during the day, but it’s a pain at night.
“Gummies” not “dummies.” I wish we could edit these comments.
Rotating work shifts? You need to join a union. Rotating work shifts are not good for anybody. This is a form of exploitation. Contact your local labor council or the AFL-CIO or Teamsters. Non-diabetics don’t tolerate this crap, why should we tolerate it? Just sayin’.
Wanacure, I agree 100%. I think split shifts could work but we’d need almost twice as much staff as we have now to make them work they way they’re supposed to. And each shift would have to be a separate job with different compensation (most people dislike the late shift so you have to pay more to incentivize it) and clearly defined roles. I’ve tried multiple times to call attention to how much burn out has increased since the split shifts have started. There’s no zookeeping union where I am right now, but the topic of forming one’s come up a few times. I think everyone’s so burnt out, though, that no one wants to step up and take the lead.
My job involves me going into crawlspaces, attics, as well tearing out damaged walls and ceilings (wet, fire, or mold). Just walking my dog my levels will drop, imagine carrying furniture around, maneuvering around ductwork in a crawlspace. Daily I snack on granola bars before a task, carry a regular coke in an attic “just in case” (and drank one coming out several times).
When not utilizing a CGM I tested 10-12 times a day but as previously mentioned would sip a coke as I crawl out as a safety valve. I can decrease my pump delivery but at times I’m unsure how hard I’ll really work. Sometimes on completion will sit over 200 on the meter and even at 50% of normal delivery saw 44 last week. Yeah I do panic eat and at times but most docs agree a little high is better than being drug from a crawlspace.
Overall I feel good even if exhausted but life’s good.
Pocket full of sustainable food. Also reduction in Basil rate if on a pump
I’m a diesel mechanic, may not seem like a physical job but it very much is. I roller coaster pretty much all day unless it’s an admin day. I’m on my feet all day lifting heavy parts, contorting my body in different ways to make a repair. It’s super difficult. I usually get about 15 minutes into something and I got to eat something or take a glucose tab to finish what I’m doing. Cleaning the shop is also probably one of the hardest things, I start walking around picking things up and I drop like a hammer.
You’re getting paid to exercise, a good thing. 🙂 You’ve got to reduce your insulin(s) and eat more and proteins, fats, veggies, fiber, yoghurt or kefir or sauerkraut, etc. That might help reduce fluctuating blood glucose. Keep those glucose tabs handy, man. Yeah, I’ve been there…loading trucks at
UPS, welding, night shift stocking groceries, etc. Carry Larabars, Luna bars, or something like that.
Yes! For years I was a professional landscaper in the summertime and did snow removal and solar panel installation in the winter.
1. Most importantly, I always had an ample supply of fast acting sugar to treat lows (It was on the roof with me). I had to restock almost everyday because lows were very common when working hard and pre-CGM.
2. I always made sure my coworkers and crew knew I was T1D…so if I started “acting crazy” they could look out for me. Helped on more than one occasion.
3. I took breaks when/as I needed them. Oftentimes break-time is prescribed. But, as a T1D, you need to advocate for yourself and bend the rules sometimes. I never took advantage, but I also didn’t sit back quietly when I knew I needed 5 minutes to test my number and eat some sugar.
Spend most of my time in front of a computer but when I do any physical labor I have to reduce my basal to 10-30% and bolus pre work by about 50%
Oh my goodness. I worked for the USPS for 24 years on the night shift that required me to continually lift heavy packages at a fast pace and push heavy equipment at a quick pace also (the equipment could weigh a good 1,000 pounds). Of course the equipment was on wheels but, but lifting and pushing heavy equipment for 8+ hours on-end constantly lowered my blood sugars. I constantly ate while working and my co-workers knew about my condition enough that that would step in and help me when I was staggering and made me eat or drink something. All of this happened before I had a cgm and insulin pump so I am sure my sugars would have been so much more controlled if I were in that work environment today. Advice? Always have a CGM and pump on, always have quick acting carbs on hand (including glucagon), and let your co-workers know what to look out for symptom-wise and tell them how to help you if needed.
Shop teacher for 9 months and construction work for 3.
I am currently a homemaker, this does not exactly relate to the question. But, I regularly clean our home (great strategy to lower BG), mow the lawn, do yard work, fill the wood rack, rake leaves, shovel snow. Each of those activities will lower my BG levels, I try to lower basal rates (pumper) in advance and have glucose tabs as well as other snacks available.
I selected other. Until I retired three years ago, I had an office job that required both speaking at public hearings, and doing field work inspecting commercial construction and mining operations. The stress levels at times were problematic, but not always.
After retirement, I have been spending my time working in the yard doing landscaping, building or repairing decks, splitting firewood, and flooring. At least working for myself allows me to take breaks whenever I feel like it. Oh, and I can enjoy a beer on the job!
While not construction or landscaping, I’m a RN. Which is pretty strenuous with turning patient’s, pushing equipment to the room to use, walking unsteady patient’s, etc. Before my pump it was extremely hard to control my sugars because as other’s have said I had to guess. Once I started pumping it was easier and starting on Dexcom was an even bigger help.
No but managing your T1D while performing physically active work is no different whether you’re getting paid or not, your T1D tools are same and there is no substitute for not having the right tools. Choose wisely.
I answered no, but Like Tod, I had a stressful job. Had to work lots of deadlines, many of which were arbitrary. I too have been retired and with considerably less stress, my BG is easier to control.
It took me a week to figure out the temp basal I needed for working night shift at a large package handling warehouse. Being flexible, having fast acting glucose, and patience helped.
Very actuve job landscaping and mixed extremely active and in office sedentary. Sometimes schedule changed unexpectedly, made things difficult on the days before pump and CGM. Now I adjust constantly for activity level.
I am in construction and can be in some positions on a job site where balance, sight and judgement can make a big difference. I use a CGM and check my BS every several minutes with a glance at the CGM value, not so much the actual value but any trends. I will treat a trend with a glucose tab or similar just to stay on the “safe” side of things.
73, supposed to be a desk guy but now a carpenter on a job I manage. Can’t find help. Glucose is a roller coaster. Dexcom G6 a lifesaver, tslim X2 as well. But I count.my blessings very often.
I’m a fitness instructor, teach 6 strength training classes a week. I wear a Dexcom because my sugar can drop 40-60 points in class. I have to start class with a higher blood sugar, around 150, and hope I don’t go low.
I was working in the stockroom of a bookstore when I was diagnosed at age 19 (while also a full time college student). In the bookstore we had to get the deliveries of boxes of heavy books and get them to the stockroom. A lot of lifting and moving of heavy boxes. Some books were put on carts to go right out on the shelves and tables by the floor staff. The rest we put into out overstock shelves. A lot of climbing up & down ladders to reach the upper shelves.
THis was in the 80s and and early 90s. I was on 2 shots a day of NPH/R. I usually had mid afternoon lows if I delayed lunch. I only worked two full days at the time and one was Sunday (no deliveries) and worked part time several other days. I remember having a few lows but nothing serious. I’m pretty sure it was because I had no health insurance, so I didn’t see a doctor for years and I’m guessing my insulin doses were too low. I was taking enough to live but my BGs were most likely running high all the time. All of the physical activity probably helped at least!
I answered “no” assuming you intended a regular job. However, I have worked to seal the exterior of log home (extensive time/efforts on a 32’ ladder), cutting down/spitting trees for firewood, etc. I have to watch my BG levels closely, even to just mow the lawn, so I don’t go low.
yes in the past but since tne vaccine I am so disregulagted that I have to retire
It affected your diabetes / blood sugar? Wow I haven’t heard of that happening!
Never heard of vaccine causing that effect before.
Sharon, a temporary rise in bg and brief symptoms of fatigue or ache might indicate the vaccine is taking effect. Did you take a Tylenol an hour before getting vaccinated? That will prevent symptoms, speaking from my personal experience. I got my booster and flu shot the same day.
If you have side effects, please report them to the place mentioned on the papers you signed before giving permission for the vaccination(s).
I worked as a union electrician for 36 years. When I was younger and doing things the hard way I had lows at work but I could tell and eat something. I had to learn to figure how to tell if I was having a low by the fact if it took me 15 minutes to do a 5 minute job I was low. Once I started to carry a blood test meter I did better. When I was younger there was no blood test meters though.
Try to take breaks at least every two hours and eat to the amount of work you are doing
I was a high school teacher-not considered strenuous but it was stressful. That caused the BG to up so high when there was a problem, such as a fight in the classroom. After I retired my doctor even said, ” now your control should be much better.”
Maureen, teachers are underpaid in Washington state. So are nurses and caregivers. Why are we closing our borders to people willing to work? Did your doctor’s prediction bear out? Meditation, yoga, exercise all have helped me cope with stress thru the years. Just walking can help. Take a hike in the mountains or foothills. Get out in nature. Get your sleep.
I am retired but I often do strenuous work at home and as a volunteer including yard work, demolition as well as building projects like decks, tamps, sheds. I just take carbs as needed. I wear a G6 CGM and buse a Tandem pump with control IQ.
It’s my personal mission to prove to myself that I can do anything physical even though I have T1d. I tried for the military but am not front line deployable. I have worked in oil fields, cell towers, tug boats. All before CGM. Looking back probably wasn’t a good idea but wasn’t option. Now working as a telecom installer. There are good and bad days but without an accurate CGM it would be so much more difficult.
I am now retired, but still do home maintenance and yard work. I am also a runner and do work outs. In my life I have done many construction related projects. My method usually involved temporary lower basal rates, and reducing the amount of insulin I bolus for meals prior to working. With Control IQ, I now have to turn off the Control IQ (temporarily) before I can set a temporary basal rate. And, I course, I reward myself during my hard labor with tasty snacks and sweet drinks, juices.
Used different Basal Rate profiles or Temp Basal rate.