Hypo/Hyperglycemic Attacks and Employer Responsibilities

[HurtMe]

I work for a very good employer (Goverment) whom works very well with me concerning my issues with diabetes.  However, being a maintainence electrician in a fossil generating plant I am occasionally asked to perform certain tasks while experiencing a hypo or hypercemic attack.  The hypoglycemic attacks are usally an easy cure but hypercemic attacks are another issue.  Just today I was sent on a mission with a blood-glucose level of 447.  I don't want to appear as a cry baby and usually attempt  to go ahead and complete the tasks at hand.  I have been diabetic for over 23 years and on insulin (Humalog and Lantus) for approx. 20 yrs.  I have been told that I am both a Type 1 and Type 2 diabetic since I have symptoms of both.  My question is are there any recommendations out there governing safe work levels during hypo or hyperglycemic attacks?  

[HurtMe]

If only there were a way for the employers to know that!  Thanks for your input and concern.

[Zoelula]

I'm glad that you don't get those kind of numbers often; we all miscalculate at times and end up where we don't want to be. You can do a search (or post on a website that gets more traffic to get others'knowledge) but I doubt there are cut and dry standards. We are all different in our ability to function at certain levels and the actual tasks we do at work vary greatly as well. But I definitely think 447 would be too high to safely function especially if your job calls for some fine-tuned physical skills.

[HurtMe]

My apologies' for misinforming you that I was Type 1 & 2.  My endocrinologist had informed me that I was a type 1.5 since I had characteristics of both.  My mistake and again my apologies'.  I agree that diabetics do respond variously to both hypo and hyperglycemic attacks however I'm not so sure about the safe functionality of highs versus lows.  It is a fact that hypo attacks can respond in a quicker time frame than hypers.  My recently mentioned episode occurred due to a misunderstanding of the carbs involved in a Subway sandwich which, by the way was purchased by our manager in appreciation for long hours of work.  Very seldom do I have these type numbers associated with hypoglycemia but on occasion it does happen.  I have been on a sliding scale for 13 years now and understand my I/C ratio very well.  Currently I require 1 unit of humalog for every 2.5 carbs ingested and 1 unit for every 3 digits on the rebound.  The 447 level was reached approximately 2 hrs. after the meal at which time the incorrect amount of injected humalog should have been peaking along with glucose.  At any rate these issues do happen occasionally and I do not expect my employer to control my diabetes.  I was only curious if any standards were available that could be utilized by the employer for safety purposes, not to be judged on my ability of control.

[jtaund]

Things like that happen to me a little too. I work at a bank and sometimes if we're short headed I don't get a lunch break until after 2 or 3. And I know on 2 occasions I had really lows because of it and almost passed out. Do the care? Not really? I still gotta stay on the line and help the people in the line.

[Zoelula]

First of all there is no such thing as being both a type 1 and a type 2. My guess is you are a type 1 who also has developed insulin resistance? We all respond differently to high blood sugars in terms of what we can or can't do. As a whole it is less dangerous to function with highs than lows if you are in fact able to do what is required for your job. But this is more relevant to moderate highs such as up to 200. When you are talking about a blood sugar of 447 you are talking about wildly out of control glucose and you are at risk for DKA. This is an emergency situation which you should be dealing with and not at work at all imho. How frequently do you get numbers like that? Do you know what caused it? If it is common for you than you need to see your doctor and reassess your insulin doses. Our insulin needs do change. Do you use an insulin: carb ratio to determine your bolus dose (your Humalog)? This is the standard of care, not a set dose as you need to dose based on the carbs you actually eat. Do you do corrections? If despite your computations you experience a high (long before it gets to 447!) you should be using correction boluses to get it back down. Any period of time we spend above 140 can lead to complications. Imho getting your blood sugar under control is your primary concern, not your employment.