Can A Type 1 Diabetic Be A Firefighter
You bet. We all know that there are certain conditions that the National Fire Protection Association recommends is automatic disqualifier. Diabetes used to be one of those disqualifiers. The latest edition of NFPA 1582, from 2007, permits diabetics to be firefighters but there are a number of strict standards.
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How Diabetes Took Being A Pilot From Me
Editors Note: People with Type 1 diabetes in Canada and the UK can fly commercially and enter the United States. Why cant people with Type 1 diabetes in United States do the same? Currently in the US, Type 1 diabetes is a disqualifying factor for both first and second-class medicals. If you have T1D, you cannot be a professional pilot.anythingso
All of the needles, lows, sleepless nights and carb counting dont bother me that much, but the fact that my dreams and ambitions were taken away, crushes me every day. I want to prove that those living with Type 1 diabetes can actually do anything though. I want to become the first professional pilot with Type 1 diabetes. I want to change the mind of those who view this disease as a disqualifying factor for this career choice. I want to defy the odds once again and make a difference for others like me. And I genuinely trust that I have what it takes to accomplish all of this. But I cant do it alone.
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Why Does It Matter
Being in the Army can be challenging both physically and mentally.Therefore, a history of health problems or the presence of health conditions that usually don’t affect your everyday life, can mean that you’re not able to join, or you might have to wait to join.
You will be sent forms asking about your medical history once you’ve submitted your application.
The medical team assess everyone individually, and make their decisions based on their professional opinion in keeping with prescribed army standards. These standards and guidelines are reviewed and amended regularly.
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Use Of Available Technologies
Established guidelines and our past experience provide a model for activity planning.Considerations include effect of rest/sleep,14 caffeine,15 type of diet ,16 environmental temperatures,17 and most importantly activity .Previously, we required each soldier to perform self-monitoring of blood glucose 6-10 or more times per day to adequately assess the effect of these and other variables.18 Remote electronic downloads provided easy information exchange, howevermultiple testing was cumbersome due to the impracticality of SMBG during activities.Use of real-time continuous glucose monitoring revolutionized testing for oursoldiers and is now a prerequisite for completion of our training program.
In particular, the Dexcom G5 is helpful as it provides the ability for our entireteam to see real-time glucose values. As an example, when a soldier is going on atimed 10-mile road march, the soldier, medical team, and unit assets are able toremotely monitor real-time values. We are able to communicate with an embeddedmedical team member and provide immediate feedback and suggestions for care. Wehighly encourage our soldiers to evaluate their real-time values, make self-caredecisions, and to communicate with our team 24/7 as the need arises. Such immediatefeedback provides invaluable lessons learned, and through repeated practice andcommunication, direct reliance on our team becomes less important.
Coast Guard Diabetes Policy In 2020
Finding information on the Coast Guard official diabetes policy was a bit more difficult than the other military branches.
As a result, OMK had a chat with a Coast Guard recruiter on their official website.
Heres what they had to say regarding their diabetes policy:
CG recruiter: Hello! How can I help you today?
OMK: Hi there, quick question. Can you join the Coast Guard if you have diabetes?
CG recruiter: Unfortunately, you wont be able to join with that condition.
OMK: ok so there are no waivers or exceptions?
CG recruiter: NO waivers. Its an absolute disqualification.
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Examples Of Diabetics Enlisting
Healthline explains that one of the first soldiers to remain enlisted after a diabetes diagnosis was Master Sergeant Mark Thompson. He collapsed while stationed in Germany and was diagnosed with type 2 diabetes in November of 2000, though he later learned he had LADA . With help from the American Diabetes Association, he collected information and research to persuade a medical board to let him stay. After getting his HbA1c down to 6 and pleading his case, he was allowed to stay.
Thompson was deployed to Iraq in 2004 for 18 months, where he experienced setbacks related to his condition. His insulin pump was crushed, and he had to wait a month for a new pump to be delivered. In between, he had to start taking up to 16 injections a day with standard hypodermic needles instead of insulin needles, and he had an episode of low blood sugar that members of his unit had to help him out with.
Overall, his waiver was accepted, then revoked, then accepted a second time. He has since returned to the United States and served as a national spokesman for persons with disabilities in the military. His story illustrates both positive and negative possibilities for diabetics serving in the Army.
Serving in the Army with a diabetes diagnosis is an uphill battle. But as technology advances, and as both soldiers and medical boards become more educated about diabetes, options for diabetic soldiers are increasing.
References
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Its important to maintain a healthy body weight. You should also make sure that you drink plenty of water, and limit your intake of sugary drinks. In addition, make sure that you get regular exercise. You should also avoid alcoholic beverages. Lastly, you should avoid alcohol. These beverages contain high amounts of sugar. If you dont drink enough, youre not doing anything to prevent diabetes. Besides, drinking alcohol can be harmful to your health.
The most important thing to do is to follow the recommended diet. Eat more healthy foods that have low amounts of fat and high amounts of fiber. The best way to lose weight is to lose 7 percent of your body weight. If youre overweight, you should try to lose 14 pounds to reduce your risk of developing type 2 diabetes. However, you should not attempt to lose weight while pregnant. Talk to your doctor about what kind of weight is safe for you.
Besides high blood glucose, diabetes can also affect the nerves and skin. It may affect your sexual response and your nervous system. It can also affect your fertility. Women with diabetes are more likely to miscarry or have a baby with a birth defect. It can cause a person to have difficulty hearing and sleep. If the condition is left untreated, it can lead to type 1 diabetes and can even lead to amputation.
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Conditions For Deployment Of Diabetics
A recent paper published in the Journal of Diabetes Science and Technology in 2018 studied the trajectories of 50 U.S. Army soldiers diagnosed with type 1 diabetes at Fort Bragg, North Carolina. This paper described a methodology whereby, with today’s advances in treatment technology, all 18 soldiers who wanted to stay on active duty were retained.
The qualities of the soldiers deemed OK to deploy included:
- HbA1c levels consistently below 7
- Presence of monofilament discrimination
- Good knowledge of sick day rules
- An ability to follow the parameters of a permanent profile.
In addition, the following factors had to be absent:
- Autonomic neuropathy
- A history of diabetic ketoacidosis in the past 6 months
- Significant comorbidities like congestive heart failure or chronic kidney disease that requires intensive management.
What You Can Do About Unfair Treatment In The Workplace
Problems in the workplace can sometimes be resolved by educating your employer about diabetes and about your medical needs.
When education isnt enough, try to negotiate a resolution to the problem. Call on others to help, including colleagues, your diabetes team, union or elected official.
Other times, you will need to take more formal action by filing a lawsuit or human rights complaint.
The federal parliament and provincial legislatures in Canada have enacted human rights legislation prohibiting discrimination on the basis of physical disability. As defined within the context of human rights law, diabetes is a disability for which discrimination is prohibited.
Although employers and others are not permitted to discriminate against people with diabetes, sometimes it occurs because of a lack of correct information about diabetes or assumptions made about diabetes.
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Meet Some Leos With Diabetes
Adam Roth took his first position in law enforcement as a Type 1 diabetic working as a cop on the beach in New Jersey. He later went to the Pentagon, where he received rigorous physical exams by the team that also conducts these examinations for the military, which can be very intimidating.
He was still able to work as a US Pentagon police officer. His current job is Department of Commerce Special Agent. He once ran into trouble when he applied to be a reserve officer with the Coast Guard, and was turned down.
When he took the case to court, the Coast Guard won. He tried to work as an EMT with a volunteer fire department in Virginia, but the fire department had banned all persons with diabetes. He also appealed this and won, and ended up working for the fire department. You can read Adams inspiring story here: .
Lt. Jose Lopez with the Miami-Dade police department was diagnosed as a Type 1 diabetic during his first probationary year. He did not tell his superiors right away, but when he did, they were very supportive. He was able to move up and work in the SWAT team, on the narcotics squad, and later even became a sergeant. He is currently serving as a lieutenant in the homicide division. You can read his story that proves diabetes will not hold you back here: .
Some frequently asked questions we received through email and facebook.
References:
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Military Recruiting And Diabetes
If youre not in the military, it can be very difficult to enlist if you have pre-diabetes, Type 1, Type 1.5 or Type 2 diabetes. Depending on the severity of your disease and your A1C, you may be able to enlist in certain positions. However, you can also consider going on a plant-based diet for many months or even a few years before enlisting.
A plaint-based diet has been shown to reverse diabetes and even has allowed some to live without insulin or any other treatment for the disease. Following a strict plant-based diet could be the answer and may allow you to get the all-clear from a doctor before enlisting in the military.
The hard part will be sticking to this type of a diet once youre in the military. While some bases and military outlets have become far healthier, its still difficult to get all the best foods during basic training and during combat. However, if you follow a plant-based diet as much as possible, you may be able to join the military and keep your diabetes from coming back.
Make sure to consult a doctor before starting any new diet. If you want to join the military, but you have pre-diabetes or diabetes, consider making some major diet changes first. This could be your ticket to joining without diabetes and to a healthier you.
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Personality Conduct And Behavior Disorders
The following conditions may disqualify you for military service:
a. Personality, conduct or behavior disorders as evidenced by frequent encounters with law enforcement agencies, antisocial attitudes or behavior, which, while not sufficient cause for administrative rejection, are tangible evidence of impaired capacity to adapt to military service.
b. Personality, conduct or behavior disorders where it is evident by history, interview or psychological testing that the degree of immaturity, instability, personality inadequacy, impulsiveness or dependency will seriously interfere with adjustment in the Army as demonstrated by repeated inability to maintain reasonable adjustment in school, with employers and fellow workers, and with other social groups.
c. Other behavior disorders including but not limited to conditions such as authenticated evidence of functional enuresis or encopresis, sleepwalking or eating disorders that are habitual or persistent occurring beyond age 12, or stammering of such a degree that the individual is normally unable to express themselves clearly or to repeat commands.
d. Specific academic skills defects, chronic history of academic skills or perceptual defects, secondary to organic or functional mental disorders that interfere with work or school after age 12. Current use of medication to improve or maintain academic skills.
e. Suicide, history of attempted or suicidal behavior.
Getting Tested For Diabetes
Diabetes is diagnosed by using one of four blood tests.
It is simple to get checked at your primary care physicians office or health clinic.
The test will measure your blood glucose level.
It basically monitors how much sugar is in your blood.
It is a really good idea to get tested for diabetes, especially if you are considering the military.
In fact, some people with diabetes do not have symptoms immediately and therefore are unaware of the disease.
The earlier you can learn of a diagnosis, the better your odds of survival just like any deadly disease.
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How Insulin Resistance Evolves Into Type 2 Diabetes And Other Costly Diseases
Insulin resistance has been brought to our attention with more studies, reports, Ted Talks, articles by doctors, and even an article I wrote, titled Biggest Health Problem in the U.S., yet there are no significant programming or dieting changes recommended by the government health and medical community. There are, however, a few in the medical and nutrition field who have been waving the red flag for years as our country is now sporting 70% overweight or obese numbers.
Now, even our military is representing those numbers as more and more active-duty members are overweight or obese. With a national Type 2 diabetes and pre-diabetes rate of 37%, it is only a matter of time before our national crisis affects the pool of military candidates on a strategic level. In fact, Type 2 diabetes has doubled in the last 10 years and quadrupled since 1980.
Currently, the number one reason why young men and women cannot join the military is that they fail to meet the height, weight and body-fat percentage minimum standards. So our nations health and wellness already has started to affect recruiting numbers.
Insulin resistance is pre-pre-diabetes and a precursor to other conditions such as a heart attack, Alzheimers Disease, cancer, kidney disease, stroke, gout, obesity and, of course, Type 2 diabetes. Recent studies are linking insulin resistance to Type 2 diabetes and Alzheimers to a degree that Alzheimers is being considered Type 3 diabetes, Dr. Georgia Ede said.
Can They Serve In The Department Of Defense
Although an individual living with diabetes is subject to discriminatory medical standards that disqualify them from a military position, they are eligible for civilian positions within the DoD. Under the Rehabilitation Act, the DoD must adopt a nondiscriminatory policy for all civilian employees and applicants, which includes roles in entities that receive DoD funding.
The DoD civilian Equal Employment Opportunity program ensures that a person will not receive unfair treatment due to their disability. This refers to all aspects of employment, including hiring, pay, job assignments, training, and promotions.
The Equal Employment Opportunity Commission guarantees that employers avoid policies or practices that exclude people living with diabetes from certain jobs. Instead, they should assess each persons ability to perform a particular role with or without reasonable accommodations.
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General And Miscellaneous Conditions And Defects
The following conditions may disqualify you for military service:
a. Allergic manifestations. A reliable history of anaphylaxis to stinging insects. Reliable history of a moderate to severe reaction to common foods, spices or food additives.
b. Any acute pathological condition, including acute communicable diseases, until recovery has occurred without sequelae.
c. Chronic metallic poisoning with lead, arsenic or silver, or beryllium or manganese.
d. Cold injury, residuals of, such as: frostbite, chilblain, immersion foot, trench foot, deep-seated ache, paresthesia, hyperhidrosis, easily traumatized skin, cyanosis, amputation of any digit or ankylosis.
e. Cold urticaria and angioedema, hereditary angioedema.
f. Filariasis, trypanosomiasis, schistosomiasis, uncinariasis or other parasitic conditions, if symptomatic or carrier states.
g. Heat pyrexia, heatstroke or sunstroke. Documented evidence of a predisposition , recurrent episodes requiring medical attention or residual injury malignant hyperthermia.
h. Industrial solvent and other chemical intoxication.
i. Motion sickness. An authenticated history of frequent incapacitating motion sickness after the 12th birthday.
j. Mycotic infection of internal organs.
k. Organ transplant recipient.
l. Presence of human immunodeficiency virus or antibody. Presence is confirmed by repeatedly reactive enzyme-linked immunoassay serological test and positive immunoelectrophoresis test, or other DOD-approved confirmatory test.
What Are The Restrictions For A Person With Type 1 Diabetes Joining The Us Armed Forces If They Are Accepted Are There Any Limits To The Jobs Offered Them
Answer:
People with diabetes cannot join the US armed services at all at present. This is discriminatory, but nobody has yet successfully challenged the US law. Only Israel and Switzerland, to my knowledge, allow non-combatant positions for folks with diabetes. All the rest of the world does not allow people with diabetes to enlist or to stay in the service because of fears of lack of medication and/or insulin reactions during critical times. This is all archaic since there are more non-combatant positions than combatant positions except in full war situations and even then this could be arranged easily, but until somebody challenges this in court, things are unlikely to change.
SBAdditional comments from Dr. Donough OBrien:
I believe the answer is that you cannot enlist. See Military Enlistment Standards.
DOBAdditional comments from Dr. Frank Varon:
I am pretty sure it is considered a pre-existing medical condition and a disqualification from entering the Armed Forces.
FVAdditional comments from David Holtzman:
The questioner can contact their local Armed Forces Recruiting Center. They will have this information. The phone number for this office is in the phone book, listed under US Government.
Stuart J. Brink, MD,
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