Living with T1D as an EMT

If you live with type 1 diabetes (t1d), you're likely aware that it's not a condition you can check in on only once in a while. Living with t1d requires constant vigilance and effort, even during periods when you have other things to think about — like work. I've learned how to balance my diabetes management needs while on the job, but it's not so simple for everyone.

One of my friends, Adam, works as an Emergency Medical Technician (EMT) and lives with t1d. Although he's primarily focused on others' health while on duty, he's been able to find ways to effectively manage his diabetes needs while at work.

I sat down with Adam to chat about how he manages this dynamic condition in the midst of such an important job. Here's what I gleaned from our conversation.

There are no "typical days" as an EMT

Adam describes his job as "unpredictable," ranging anywhere from slow to extremely fast-paced. A few of the standard daily tasks include:

• Preparing the ambulance, double-checking equipment, and replacing any supplies
• Entering the 911 system and waiting for emergency calls
• Dispatching to a variety of calls, from simple lift assists (for people who fell down and need help getting back up) to life-threatening emergencies
• Cleaning the ambulance and replacing any used supplies

Amid all of this action and activity, Adam still finds time to ensure his glucose is in range. Technology plays a big part.

For his primary insulin delivery system, Adam uses a Tandem t:slim X2 insulin pump. And to keep an eye on blood sugar, he uses a continuous glucose monitor (CGM).

"I use a Dexcom G6 CGM to monitor my sugars. The G6 is connected by Bluetooth to both my pump and cellphone," he said. "The G6 integration with my pump allows the pump to increase or decrease the amount of insulin I get depending on how my numbers are trending."

A mental checklist (and backups) are essential

Like most of us living with t1d, Adam has a mental checklist before he heads out the door for an EMT shift. In addition to ensuring he has his keys and wallet, he asks himself the following questions:

• Is my pump in working order, and will the insulin/battery last through my shift?
• Do I have all my backup pump supplies and insulin?
• Do I have a source of quick sugar?

Adam noted he also takes care to prepare for potential contingencies. He always brings a backup vial of insulin, an extra set of tubing, and a cartridge, plus at least two forms of backup sugar. To get through his shift, he usually brings a soda, juice, or sports drink. "Then I have some slower-acting snacks that act more as a preventative, to keep my sugars stable," he said. "This may be a protein shake, yogurt, or other small snacks."

Managing diabetes at work

It's clear Adam's dedication to his job drives him to tightly manage his diabetes. He said there are no standard EMT tasks that he can't do because of t1d. And he's always on top of his trends because the calls can come at any moment and have a range of responses.

"When responding to an emergency, it can be as simple as drive a few minutes and transport a patient to a hospital a few miles away, or we could end up driving 30 minutes just to reach a patient, treat the patient, and then drive them to the nearest hospital," Adam said. "Throughout that whole time, I have to be extremely focused and not worried about my diabetes."

Additionally, Adam mentioned he always has a backup glucometer on hand, just in case his CGM sensor stops working while on duty. Plus, he's able to "feel" when high and low blood sugar events may be occurring, so he has an idea of when it's time to manage his needs.

Serving others while meeting your needs

When I asked Adam if he had anything else to share about his experience as an EMT with t1d, he opened up about not letting t1d hold you back.

"Working in emergency medical services with t1d can be really challenging at times, but it is a job that I love and I'm definitely not going to let my t1d get in the way of that," Adam said. "So, to everyone else out there that is working in a job that is especially tough with t1d, I wish you the best of luck! If you put in the work, you will be successful and rise above your challenges."

Interesting in more tips for managing type 1 diabetes? Check out the library of stories on Health Insights.