Social Issues for the Type 1 Diabetic

Diabetes is more than a health condition. For most people, it’s a new way of life, and it affects relationships in all areas as much as it affects eating and physical activity.

School
The first challenge facing parents of a Type 1 diabetes student is the ongoing medical care required during school hours. The “School Bill of Rights for Children with Diabetes” requires that diabetic children be allowed to:
  • Check blood sugar
  • Use emergency sugar to treat hypoglycemia
  • Inject insulin, eat snacks, drink water, and use the bathroom whenever necessary
  • Eat lunch at an appropriate time, and with enough time to finish
  • Participate fully in all activities
It’s up to the parents to be sure the school officials, nurse(s), teachers, and all other applicable staff are educated to and comply with their child’s needs. Having a section 504 plan will help.

The second challenge is helping your child fit in. Often other children will not have any experience with or understanding of diabetes. Coupled with a perception that the child is being treated “specially,” that can lead to teasing and even bullying. Talk to your child about how to educate their friends and classmates about what’s going on. Perhaps you’d be able to be a guest speaker in their classroom.

Parents of your child’s friends may need education, too. Some parents are concerned about how to handle your child’s condition at a party or other event. Leaders of scout troops and clubs, as well as coaches and youth group volunteers can also be recruited onto your team.

Throughout your child’s education, communication with many of the people with whom they come in contact will be key to productive, healthy, fun experiences.

Sports
Sports are an important part of many people’s lives. Teamwork, camaraderie, and physical activity are vital parts of a well-rounded life. Diabetes doesn’t have to alter that. Exercise is essential in diabetes management, and participation in sports can provide this and other benefits. But it does require some extra effort by the diabetic.

One important component is tracking the effect of exercise on glucose levels, reacting to changes with Insulin or food. The varying lengths and intensity of games and practices will need to be accommodated.

Another important factor is incorporating the team concept. The coach should be educated and prepared, and alert to the child’s needs. It’s a good idea to set up an advance meeting, rather than try to discuss all the factors at the first practice. Letting the player’s teammates know about the diabetes and the player’s needs is a good idea, too.

Children aren’t the only ones who should follow these guidelines. An adult playing a sport may have a solid handle on their own management, but should be sure the coach and teammates will be prepared to help in the event of emergency.

Nylon bracelets that say “Type 1 diabetes” are available as alternatives to metal medical jewelry.

College
Going away to college for the first time is a challenge for anyone, but it’s even more so for the Type 1 diabetic. There’s the resurgence of the need to be like everyone else, to fit into a new environment with new people. They are probably facing more responsibility for their own diet, exercise, testing, and medical care. And they face the same temptations all college students face, including inconsistent hours, not enough sleep, parties with alcohol, and dealing with the stress of schoolwork and relationships.

Here are some tips to help make the transition go smoothly:
  • Visit the health center and meet with health professionals, investigate local off-campus health care, and perhaps get a referral to a local physician. Make sure the student has all the health insurance information.
  • Meet with the resident assistant and, if possible, communicate with the roommate(s) ahead of time. Make sure they understand your student’s needs and know that any snacks or food need to be left alone. Buying a refrigerator just for your student is a good idea.
  • Plan a buddy system for parties and events. You should try to always have someone around who knows what to do if you have a reaction.
  • Stick to your plan! All the meal planning and testing schedules you had before are even more important now. Be prepared to adjust for different glucose reactions to the new levels of activity, stress, routines, etc.
On the Job
By the time a person with Type 1 diabetes enters the work force, they likely have had their condition for some time and understand their requirements. There are no concrete steps to follow when meshing work and diabetes, because each person’s situation is different. In certain jobs, it may not ever be necessary for the employer or coworkers to know you have diabetes. In other situations, reasonable accommodation may have to be requested under ADA.

Here are some factors to consider:
  • Is the job flexible so you can monitor glucose, eat snacks, and/or take insulin? If the specifics of the job or work environment don’t automatically accommodate these needs, talk to your employer about adjusting the requirements of your position or schedule.
  • Does the job require the employee to do activities that could be dangerous in the occasion of hypoglycemia?· Do certain requirements of the job, such as rotating to a midnight shift, cause disruptions of sleep cycles and meal times to the extent that glucose levels become difficult to manage? In such a case, a doctor’s letter may help you get the employer to accommodate this.
The diabetic’s planning skills will come in handy as they embark on any new job venture.

Military Service
Federal laws prohibit most employers from making a blanket ban on any kind of disability. In other words, they must consider each situation individually before deciding it is dangerous or impossible to accommodate the needs of a diabetic in their employ. This doesn’t, however, apply to the military. The concern is that any member of the military must be able to perform their duties without exception. Therefore, it is nearly impossible to enlist with a pre-existing diagnosis of Type 1 (or Type 2) diabetes. Discharge is common of those diagnosed after already being in the service.

However, there are exceptions, and a few Type 1 diabetics have even been allowed in combat situations. There are two factors essential to this success: excellent management of your diabetes, and testimony from health professionals that diabetes will not interfere with your ability to do your job.

Support Groups
At any stage of life, knowing others who have been through the same experiences as you have, or that you are about to endure, can help you through. Socializing with people who understand your needs and responsibilities can be relaxing and fun. And helping others get through things you’ve already mastered may be most rewarding of all.

Local and online support groups abound, found with a simple search, via links from diabetic associations, or via referral from your doctor or nutritionist. They can make a major difference in how you handle your diabetes.