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Diabetics as Firefighters

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  • SceneIsSafeBSI
    replied
    In response to one of the posters:

    Just for clarification sake, and a little education for those non-type 1's out there reading this, there are two types of diabetes, as referenced here. Type 1 is what used to be called "juvenile diabetes" and although it can appear at any age, it develops predominately in children/teens/young adults.

    It is an autoimmune disease with no known cause and no cure. Nothing can be done to prevent it. No, the little skinny 9 y/o with type 1 did NOT eat too many sweets to cause this, for some reason his immune system is attacking his insulin-producing beta cells. Type-1 generally involves destruction of all insulin producing cells in the pancreas and thus means that a type-1 without supplemental insulin will not live for more than a few days.

    Some people can control their blood sugar to within normal limits by testing very often (10-12x/day) and using either multiple injections per day or an insulin pump, a little pager like device that dispenses background insulin constantly, and can be manually adjusted to deliver more or less insulin based on a person's activity level.

    Type 2 diabetes is caused by insulin resistance, or the bodies inability to utilize its own insulin. Although lifestyle is not the sole cause (as evidenced by the fact that all overweight people don't develop type-2), there are a variety of lifestyle changes that can be made to help prevent it, namely losing weight. It can progress from diet controlled to oral meds to insulin dependent, and depending on the person and type of care they are taking in the management of the disease, can go off of insulin after being on it a while. However, being insulin dependent does not necessarily make you a type-1, and if you eventually go OFF of insulin after being on it, you are definitely not a type-1. Not all type-2's are fat and not all type 1's are skinny, although both of those do hold true a lot of the time.

    It seems even ff/EMT's are ill-informed about these differences, as the Basic curriculum has very little info on type-1 vs. type-2. Hope this all makes sense, usually people have no reason to learn the differences unless they know someone directly affected by type 1.

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  • hydrotech
    replied
    this is a great post i have had type 1 diabetes since fourteen and had it under control for a while till my meter miss coded and i had a lot of lows.aside from that i am on track with it again and doing better i am new to firefighting in general and wanted to know one question that i haven't heard addressed yet. my question is to all the diabetic firefighters out there is what do you typically aim for numbers wise on a fire call?


    P.S. i am the one of ten diabetics that adrenaline lowers my glucose levels.


    thanks in advance for the advice!

    Leave a comment:


  • RFDACM02
    replied
    Look at NFPA 1582. Specifically section 9.6.3 and on. This talks about Type 1 and 2 insulin dependant diabetics. It basically says the firefighter w/ diabetes without specific ongoing testing should not be cleared for three job tasks. These three include wearing PPE that could cause overheating and fluid loss, operate for long periods in an emergency without time to maintain self, and working as a member of a team where you must be relied on.

    Purely informational. This is a tough issue, with alot at stake. Regardless of what medical or physical condition you're in, you must be counted on to give 110% at any given time for an undetermined amount of time. This is hard for tons of firefighters to do.

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  • Remthedays
    replied
    It can be done

    To make a long story short I had to retire for my full time job as a L.E.O. (Do not bash me to hard, been a POC/Vollie FF for 35 yrs). Anyway I went from 225 lbs to 315, Type 2 to Type 1, Insulin dependent. In december 2005 I new I had to change my life if I wanted to be around for my kids and 10 grand children.

    So I started to diet and exercise, and in december 2006 I was taken off insulin (No more needles) and went back to pills. My A1C went from 9.0 to 6.0. And dropped down to 256 lbs. Yesterday went to doctor my A1C had went up to 6.3 (eating a little different) and weight had dropped to 240 (Yea still losing). Heart and trigliserites (sp) all blood work great. I went back to volunteer department last July and doctor said I was good to go for my duties.. I had never had a problem with my diabeties causing a problem in the past, I knew what to watch for. But it is even better now. I have had great support from family and the members of the department. So those that have a weight problem and the doctor tells you to lose that weight and work out DO NOT SAY IT CAN NOT BE DONE, because it can.

    Stay safe and healthy.

    T.J.

    Leave a comment:


  • TC33FF
    replied
    I have worked with a few diabetic FF's. They know when they need sugar or help. Never had an issue with any of them.

    Leave a comment:


  • metzgeJP
    replied
    Im a Volunteer firefighter right now, and am an insulin dependent diabetic. I am in college right now and am trying to pick my major. i want to be a firefighter but want to know for sure if i can be one. I dont want to go through school, and then find out it is impossible for me to become a firefighter. And also want to know if it is possible what steps do i need to take to do so. Oh and also i was told that if i did try that they would come up with a reason to turn me down. How can i make sure this wont happen?

    Leave a comment:


  • Lewiston2Capt
    replied
    I keep glucose tablets, and a tube of cake mate in my gear (cant stand the taste of the liquid glucose makes me wanna puke) and for the middle of the night calls I grab a can of high calorie supplement drink (Boost) and chug it. Keeps me going when my meal plan didnt quit anticipate that much activity.

    Come on guys lets keep this one going!

    Leave a comment:


  • truck197
    replied
    Capt and all the others,
    I think that a thread for us to discuss what we have learned is not only a good idea, but also way overdue. I think that we could use this forum to help each other out so that we can do the job that we love, with out becoming liabilities. It is this kind of topic that the forums were intended to serve, not the BS “this department sucks,” or “I think I know more than you and I can prove it here” type threads.
    I want to know what you guys keep in your turn out gear for low supplies. I have a couple of tubes of liquid glucose (if I am really exhausted and sweaty the last thing I want is something really chewy), some of those tubes of orange CVS glucose pills, and my personal favorite, the twizzlers. I don’t like chocolate products because on non-fire calls I find that my body heat can be enough to melt them. That’s it for me, let me know what you guys do.
    Jeff
    Never Stop Learning

    Leave a comment:


  • Lewiston2Capt
    replied
    Hotdog email me if you could I have some questions I would like to get together with you on. I too am an insulin depedent diabetic, and have found ways to prevent the mid-meal call problem. I eat then take insulin, food is in and then I can make sure I have the insulin to manage it. I realize this forum is about careers in the fire service but I thought that it may be a jumping off point for all diabetics firefighters to get together and share thoughts, suggestions, and benefit from others experience.

    Leave a comment:


  • EC116
    replied
    So oldman, what you're saying is we are supposed to sit back and take it easy, relax and not do anything "just in case" something happens. No, I don't think so. If I have a problem, I take care of it. Otherwise I go about my job in the way everyone else does. I'm not going to not do something for fear that i might have an insulin reaction. If I do, I take a break, take care of it, and get back in there. It's not like I'm going to be standing one minute and passed out the next, where someones going to have to rescue me. Hypoglycemia has warning signs, and as long as you listen to your body you can see those warning signs and do something to counteract them.

    As for being a "liability"..well, oh well. So is the old guy who might have a heart attack from overexertion or the fat guy who doesn't take care of himself. They are still allowed to fight fires, so why shouldn't I?

    Leave a comment:


  • HOTDOG
    replied
    OldE6man,

    I thank you for your civil response. I appologize if I came across as defensive, but this is a sensitive area for me and sometimes I take comments personally.

    I can understand your stance after reading your second post. Maybe I am the exception to the rule. I just take for granted sometimes, that all diabetics take care of themselves the way they should. Diabetes is definatly not something to be shrugged off.

    The point I am trying to make is, as long as one knows his limitations and is "in tune" with his/her body, diabetes is not something that will limit what he/she is capable of doing. However, if one is not "in tune" with his body, then you are correct, there can be devastating consequences. If you know anything about Diabetes, you can tell after hanging around with someone if they take care of themself or not.

    To answer your statement about my needle, I agree with you to an extent, however precautions can be taken to prevent an accident, and again, knowing my body I do things in a way that prevent episodes of glucose imbalance. To date my little system has worked, but with everything there is always a chance...

    Again I apoligize if I offended you. I take great pride in what I do and love it more than anything. I strive to do the best I can and, as anyone who takes pride in themselves and what they do, tend to get defensive at times.

    God Bless Firefighters and God Bless FDNY!!

    Leave a comment:


  • oldE6man
    replied
    Hotdog, your response is precisely the reason that I usually read others' posts and keep my opinions to myself. Bus since you have thrown down the gauntlet, I am compelled to respond.

    I am not a diabetic, but I do have some insight into what physical limitations a diabetic has, and how hypoglycemia and hyperglycemia affect a firefighter's ability to perform his or her duties, expecially under the extremes of intense interior suppression operations.

    I served a tour in charge of the occupational medicine facility for a large department. In that capacity, I worked with physicians who are nationally recognized for work in occupational medicine and health. We studied ADA, OSHA regulations, and appropriate NFPA standards on firefighter health and safety issues. I have also been a union official and advocate for firefighters. I hope that qualifies me as more than a loudmouth backstep guy with more opinion than fact.

    Diabetes is one of the most difficult conditions for the fire service to consider. For persons like you, who obviously are very 'in tune' with their bodies, and take steps to minimize the impact that an insulin/glucose imbalance can have on your ability to perform your duties, there is a significantly lower risk of problems. Unfortunately, it has been my experience that firefighters like you are the exception rather than the rule.

    Your comment about 'Mr. Needle' addresses my concerns again. Since the fire service is far from a controlled environment, you cannot predict that 'the big one' won't happen fifteen seconds before or after you have injected yourself, when your levels would need regulation. At that instant, you might have to charge out the door for an extended duration incident.

    I hope you don't interpret my remarks as a personal affront. I just think this is a very thorny issue for the fire service, and it cannot be dismissed by a few 'feel-good' posts.

    Leave a comment:


  • HOTDOG
    replied
    I have been an insulin dependent firefighter for about 10 years now. I have yet to have any problem with performance on an interior attack, much less any other task I am assigned.

    It is all about knowing your body. I know my body better than most, and it is because I have to know my body in order to function properly. I eat proper, exercise and take care of myself, much better than people with no disease at all.

    I hate to see someone, not to mention any names (OldE6man), who knows nothing about what a diabetic can do or must do, knows nothing about physical limitations of diabetics or how our illness can affect our physical abilities. It angers me.

    Come to my department. I guarantee that the only time you will know I am a diabetic is when the dinner bell rings and I must go get Mr. Needle to take care of business. As far as interior attack, ask my brothers if any doubt enters their mind if I am behind them or vice versa...I am sure they will tell you no, Hell NO!! If doubt entered their mind, I would not be doing what I do because I know their life, as well as mine, is on the line each and every call. But I would not expect your closed mind to comprehend what I am saying, so I'll end it here.

    Truck197, my hats are off to you. I'd follow you to hell and back and you'd better bet your sweet backside that I'll have that hinee covered!!!

    Leave a comment:


  • truck197
    replied
    E6,
    I will admit it quite openly; I have not been in the fire service that long, and I run with a rural, relatively low call volume volly department. That much being admitted, I have to say that I enjoy hearing what those with different experiences have to say, but I must disagree. I appreciate what you are saying, that diabetics have an added constraint, but I do not believe that this should eliminate them from interior operations. I have not met a firefighter who is ‘ideal.’ Every guy out there has a variety of issues, physical and otherwise, which they must overcome on the fireground. Its just a plain fact that we all have our obstacles to overcome. By your logic some great firefighters who I know should not be doing interior work because, in the same collapse situation, they just plain lack the upper body strength to perform that evolution. No matter what some of these guys do they are not going overcome that physical obstacle, the only way to do this would be by changing their body. Rather, they are going to use their experience and training to compensate for what they don’t have, just like a diabetic firefighter.
    Keep safe,
    Jeff

    Leave a comment:


  • oldE6man
    replied
    I hate to be the one to pee in the Cheerios, but I have a problem with insulin-dependent diabetics performing suppression activities. One of the previous postings made the case by stating that his first working fire caused him problems. If the situation had gone sour (as all veteran firefighters have experienced), and his partner had become entrapped by a falling wall, etc, this firefighter may have been unable to effect a positive outcome.

    I know that many diabetics regulate their insulin and glucose levels well, but the chance of extreme exertion is always lurking in the background in our profession. If a diabetic is unable to control his environment (and he certainly cannot control it in a hostile fire situation), I think he could be a liability.

    Leave a comment:

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