With Diabetes You Can Be Anything You Want (Except for Anything a Four Year Old Wants to Be)

Cowritten with my (pretty ace) husband, Ben.

We all worry about our kids’ future. Will they be happy? Kind? Financially secure? Often, we find ourselves wondering what they’ll do when they’re all grown up.

The good news is that Type 1 Diabetes doesn’t close too many doors when it comes to potential careers. Except, of course, for every possible occupation our T1D son wants to pursue. 

Diabetes in the Workplace

Diabetes can be intrusive, but it’s not prohibitive for most careers. Dosing for carbs, correcting blood sugars, even changing infusion sets and CGM sensors are all feasible in an office setting. 

Famous actors, musicians, and athletes all manage their glucose while touring and performing in front of large crowds.  Supreme Court Justice Sonia Sotomayor writes kickass legal opinions. She passes judgements with society-reaching implications. All while (I imagine) knocking back juice boxes to prevent those pesky lows. 

In the US, Diabetes is covered under the Americans with Disabilities Act. This legislation provides protection from discrimination in the workplace and mandates reasonable accommodations for those managing the disease. Similar legislation is in place for many other OECD countries, but there are often exceptions or categories of work that are exempted from these protections.

In the UK, for instance, fire and ambulance services are allowed to not to hire individuals with conditions like T1D. Other positions, such as air traffic controllers, pilots, etc. also fall under these protections. It’s a similar story here in the US.

A Four Year Old’s Career Aspirations

Well, guess what types of jobs a four year old thinks are cool? You guessed it. Our kid wants to be (in no particular order, rotating on a weekly/sometimes daily basis) an astronaut, a fire fighter, a pilot, and a pirate (we’ll call it maritime professional).

Fortunately, we all change our minds as we grow up, and learn more about ourselves and the rest of the world. But as a parent, you never want any opportunity to be off-limits for your child. 

We entered discussions before our son was even born about whether he should be born in the UK or the US. Logic being that if he was born in the UK, a certain husband of mine feared that he wouldn’t be able to run for president one day. Not that we actually anticipate he will ever want to run for president, but we weren’t going to crush the kid’s dreams before he was even out of the womb. Birth in the US it was.

It’s a different conversation with a four year old. It’s a hard conversation. So we’ve elected not to have it. 

The Changing World

This decision isn’t just avoidance on our part. The thing is, we really don’t know what the world is going to look like in the next 15 to 18+ years. Diabetes is changing. The workplace is changing. 

Doors are opening.  

For starters, the technology available to diabetics is evolving rapidly. Even in the 21 months since our son was diagnosed, a new glucose monitoring system has passed through the stringent FDA approval process and has made it to market. Smart insulin pumps which ‘talk’ with glucose monitors are available from several manufacturers.

With the caveat that many of these technologies are (beyond frustratingly) only within reach for those with good insurance, these advances dramatically improve glucose control and lower A1Cs, all while decreasing the risk of severe hypoglycemic episodes.

With better monitoring and management, a diabetic poses little to no additional risk to most employers over someone with a fully functioning pancreas. Employers are catching on to this. Slowly.

Even the aviation industry, an appropriately risk averse sector, is evolving. Since the mid-nineties, diabetics have been able to fly private aircrafts or fly as a student or test pilot. They have been barred, however, from commercial airlines – at least in the US – but the ADA is on the case.

In even happier news, the FBI has indicated that it will consider hiring those with “well managed” Type 1 Diabetes, and positions as a Foreign Service Officer or a Police Officer are now within reach. Even for budding astronauts, there’s a light at the end of the tunnel; while there haven’t been any Type 1 Diabetics in space until now, there is a man who’s hoping to be the first: Josu Feijoo. This next step in space travel would be transformative for Type 1 Diabetics like our child, who could one day make it up to see the stars because of this man, who kept on fighting.

Our boy wants to be an astronaut. He wants to go to Mars and see if it has gravity too (middle school physics might need to come with a spoiler alert). He wants to see “consternations” (constellations) from his rocket ship, and bring snacks for the aliens he’s pretty sure exist on Mercury (there are only four of them – don’t panic. They like ice pops and s’mores but they don’t like snakes or loud noises at all).

We’re going to support him in that dream, if it sticks. This means shelling out for space camp, and figuring out how to make a space helmet for halloween costumes. It means being a stickler about math homework. It means advocating for more research and better protection under the law. It means investing in better technology and being disciplined in its use.

Goddamnit, it means telling Elon Musk that California says he can’t hire diabetics to pilot SpaceX’s rockets.

Most importantly, though, it means letting the kid dream. It means not letting Diabetes get in his way. 

Helpful Links:

An Employer’s Guide to Type 1 (Beyond Type 1)

Laws that Protect People with Diabetes (Beyond Type 1)

Diabetes and Employment (Diabetes UK)

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