Diabetic Firefighters?

[BayRidge60]

After having an "elevated blood pressure" during ACL reconstructive surgery in July, my surgeon wanted me to have it checked out. He referred me to a friend of his and I went to meet with the guy. He sent me for lab work to see what was going on and low and behold...he tells me I'm diabetic. Type 1. This was back in August. Now, I'm on insulin twice a day and thankfully I haven't had to change my injection time due to being on a call...yet. Is there anyone else out there living with diabetes and what problems have you run into because of being a firefighter?

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Glenn Ralston
Firefighter/EMT-D
Bay Ridge Fire-Rescue
Queensbury, New York

[S. Cook]

No problems here, type II, non-insulin dependant, taking 5mg Glyburide a day, diagnosed in November 2000.

A diet switch may help you get off or reduce the insulin. Try a mostly protien (less than 20g of carbs) diet.

When diagnosed..

Glucose - 390
Chloesterol - 316
Triglycerides - 1260
Weight - 284

After 2 weeks on the glyburide and a "diabetes diet", glucose down to ~160 weight contstant)

Then I switched my diet to a protien diet. After the first week on it, my glucose held in the 80s (still with the glyburide). After my 4 week checkup...

Glucose - 90
Cholesterol - <100 (too low, got to get it back up, med halved here)
Triglycerides - 160
Weight - 255

Now that the holidays are over I can get serious about it again and see where it goes. My goal is to get off all meds in the next 6 months.

I keep Met-Rx handy in the event I get to feeling sluggish.

[Captain Gonzo]

There have been two firefighters on my Department (one active, one retired) that are diabetic. In the time I have known them, there has been only one episode of a diabetic emergency between them, and it was because of the firefighter getting the wrong insulin from the pharmacy.

Having diabetes has not affected their work whatsoever. if you are in control of your diabetes, then I feel it's not an issue.

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And on the eighth day...God created Firefighters!
Captain Gonzo

[Natalie]

First, we need to clarify that there are two types of diabetes...Type I and Type II. Type I diabetics do not make any insulin at all...they do not have the option of taking pills...they must take insulin, watch their weight and diet, and exercise. A Type I diabetic could be extremely thin, but would still need the shots since the body does not produce any insulin to cover the blood sugars. Type II diabetics make some insulin but the pancreas cannot keep up with the body...that is why weight, diet, and exercise can really help them get off medication (pills). I have been a Type I diabetic since I was 12. Since then, I've had to take two shots a day and constantly monitor my blood sugar, diet, and exercise. For 3 years, I worked the 24/48 hour shift, first as a firefighter, then I was promoted to Sergeant and became the driver for the shift. I have had some low blood sugars while working, but I've always recognized them and have taken the glucose tablets I carry in my gear. I thought it also important to make sure that every crew member that I worked with was aware that I had diabetes. I even let some of them give me my shots! Just be upfront that you have diabetes (whether it's Type I or Type II)...everybody has something to overcome in life...diabetes just happens to one of those things for you. Sure, you have to be more aware of what goes on with your body, but diabetes doesn't have to stop you from doing what you love!

[Lieut706]

In NFPA standards for physical reqiurements for firefighting they cover the diabetic firefighter. what they are interested in is the occurance of hypogylcemic episodes and if they interfere with emergency work. If you have good control and can stay on top of your low periods, like the previous post, then there should be no problem. Be aware thought that diabetics are more prone to vascular, cardiac, and wound healing problems. Self awareness is the key to health and saftey. Periods of intense physical activity, (firefighting) will alter insulin requirements, so keeping on top of your blood sugars is important.

[HOTDOG]

Like yourself, I am an insulin dependant diabetic on two shots a day. I have had some close calls where just about the time I have sat down to eat the alarm goes out. I am on a volunteer only dept. and am the primary driver. I try to keep some glucose tablets in my gear for situations where my glucose level drops, as it has when working a fire. I commend all you diabetics out there who are tough enough to prove that with proper diet and exercise, there is nothing we cannot do. I have competed in several local FF challenges and have placed at least third in all, even won one of them. Just make everyone aware of the potential problems diabetes can cause and recognize your own problems before they become serious. You can ask anyone on my dept and they will tell you it has not affected my performance in the least!!

Take care of yourself and give 'em hell!!!

[tjm]

'Lieut 706' refers to NFPA standards that address diabetic firefighters. Does anyone know which standard and whether it addresses diabetics specifically? Also, does anyone have info on ADA cases involving diabetic firefighters?

[This message has been edited by tjm (edited 02-06-2001).]

[Lewiston2Capt]

I have been thinking about starting a thread on the very same topic. It is definitely reassuring to know that there successful diabetics in the fire service.
I have been a type 1 diabetic since the age of 16 and joined the my Volunteer fire department 4 years later. I have had some problems but only when my doctor had made dosage changes and i end up performing some intense physical activity before I can adjust.
I to keep glucose tablts in my gear for when I have lows, and since we have the scott 2.2s I dont even have to remove my mask to take them.
I am on four insulin shots a day (test four times a day too), and I mix Humalog and Humulin N. I have fou the four shots maintain my glucose levels better than the two shots a day. It was a pain at first but I got used to it, quickly.
Just a suggestion that we try to keep this thread going, that way if any of us have problems or discover new tricks we can post them and help each other out.


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Shawn M. Cecula
Captain
Lewiston Fire Co. No. 2

[truck197]

I have been diabetic since age 7, and have been in a vollie department since age 18 (when I went to college) and I am now 21. Being diabetic and a firefighter poses some very interesting question. How well do you recognize your low and high bloodsugars? It can be extemely dangerous to undertake strenous physical activity when your bloodsugars are at either extreme. What would you do if a call lasted through a time when you were supposed to take a shot or eat? Also, how aware are your fellow firefighters of your situation. My solution to many of the problems we face being both diabetic and firefighters was the insulin pump. In my opinion it it offers the best opportunity for the best control. I never leave the house with out it(even in the middle of the night I know it is there), I do not have to eat at prescribed times and it is like taking one shot every three days as opposed to 4 a day. The only problem I had was that I wore it into a working house fire and ruined the insulin, but that was just my stupidity. I just unclip it and leave it in the jumpseat right next to my glasses. On the non-firefighing side, my blood work has never been better. MiniMed is a great company to deal with, and they are advocates for their customers. Ask your doctor and look into it, and constantly be looking for ways to better manage the situation that you have been given.

[This message has been edited by truck197 (edited 02-07-2001).]

[flash32]

on the dept i'm with we have two members that i know of that diabetic. one of them is our tanker driver(or what ever else needs to be taken out). we can always count on him. i believe that he is insulin dependent. he brings his emergency insulin kit with him and sticks it in the cooler in his truck, along with something to drink. and the other is my father. he was non-insulin dependent but was recently put on insulin. as of now niether one of them have had any problems when on a call.

[Lewiston2Capt]

Truck 197:

I have been told about the pump. One of my concerns is the extra object on my belt, I already have two pagers and a Gerber tool on my belt anything else woud make me feel like Batman. The discomfort of having a catheter in my stomach (or whatever site I can use) is another. I have considered it for the reason you mentioned. Frequently if we have a call during meal time the meal is postponed until I get back. I dont take my insulin until after I eat for that reason. (The Humalog begins acting five minutes after injection) Midnight calls I can grab a can of Boost or slimfast on the way out the door.
I am curious about the pump. My fiancee just worries about me snaging the tubing on something, or ruining the insulin without knowing it.
I would be interested in hearing some answers from someone in the same position I am. Thanks for the suggestion.



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Shawn M. Cecula
Captain
Lewiston Fire Co. No. 2

[truck197]

Lewiston2Capt: As to your first concern about another thing on your belt, that is just a personal thing. The pump looks like a normal pager except that it has some tubing coming out of the top. I feel awkward with both my FD pager and the pump, but I got used to it. As to the catheter in your stomach, it does not bother me at all, it is tiny and I often forget where it is. Don't be worried about running out of insulin, the pump has alarms (low battery, no delivery) that work very well. Also, you should have a very good idea as to the amount of insulin you have left (they say to put in a 3 day supply) and you can just open the thing up and look at the reservoir. I personally just tuck the tubing into my pants when I get dressed. The only time I have had problems were just carelessness (there are a few good stories there). I rarely push a product, because I believe that what matters most is what fits you and the situation best, but give minimed a call and they will send you more info than I can give you. (800)933-3322

[This message has been edited by truck197 (edited 02-08-2001).]

[Lewiston2Capt]

TKS Truck 197. What are your thoughts on keeping this thread active for discussion on relavant topics? Anyone?



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Shawn M. Cecula
Captain
Lewiston Fire Co. No. 2

[tracyant]

I have hypoglycemia pretty bad and it can strike at anytime. Most times there is sufficient warning before my sugar gets too low. It is important to have glucose jell or tablets on hand, and react to the low sugar warning as soon as possible. Make sure everyone you work with knows about your condition.

[PFraser]

I'm also a type 1 on a pump have never had any problems with it while in service. The minimed is a good pump but I think the diestronic Htron plus is a tougher (also waterproof) pump that stands up to what we do a little better. also I carry the gluc tabs and in each truck there is my old stand by a 12oz DR Pepper and a pack of nabs. Also use Humalog and test 4x daily and as needed. Stay safe