Managing Diabetes in a Professional Environment

A Personal Reflection on Managing Diabetes at Work and in Life

Why am I writing this blog?

I had a recent conversation with a client that made me think about writing this blog. Diabetes in general is relatively misunderstood. I hope I can raise awareness of the condition and offer support to others who face the challenge of serious health conditions while also getting on with their work and life.

As the CEO of a great and vibrant company I do have some insight into what it means to have a busy working life while managing a serious health condition. My condition is Type 1 diabetes.

What is Type 1 Diabetes?

There are two main types of Diabetes. Type 2 is most common (92% of cases), which is primarily related to lifestyle i.e. weight and diet. Type 2 is controlled with medication and dietary changes.

Type 1 is less common (8%). This is where my blood sugar (glucose) is too high as my body doesn’t make the insulin hormone. My body attacks the pancreas cells that make insulin, meaning none is produced. Insulin is critical. It allows the glucose in our blood to enter our cells and provide fuel. 

Type 1s still break down the carbohydrate from food and drink to turn it into glucose, but when the glucose enters their bloodstream, there is no insulin present which allows the glucose into their cells. Glucose then builds up in the bloodstream, leading to high blood sugar levels which damage vital organs, such as heart, eyes, and kidneys.

To reduce the impact of a Type 1 Diabetics pancreas not producing the hormone, insulin must be injected on a regular basis to counter-act any carbohydrates that have been eaten.

How did my diagnosis come about?

I am somewhat unusual in that I was diagnosed later in life in 2017 at age 43. I woke up one day feeling something akin to a hangover from hell, for no apparent reason. Some of the main Type 1 symptoms are excessive thirst and tiredness.

What followed was a 3-month period of NHS evaluation before they could confirm my Type 1 diagnosis. During that period I lost 3 stone. I was not overweight at the time, so this had a huge impact on my general health. None of my clothes fitted, and I looked terrible. Once the diagnosis was confirmed, I immediately started injecting insulin. Within 3 months my lost weight returned.

How has it impacted me?

Type 1 has had a substantial impact on me, both mentally and physically. From a mental perspective this was the first time that I really thought about my realistic life expectancy. I was relatively healthy at that point. I played sports, walked, was about the ideal weight with a decent diet. I also had some vices, such as enjoying a drink and smoking, both of which I still do but to a lesser extent.

One of the biggest impacts was the question of why did this happen? I will never know. Doctors are regularly finding out new information about Type 1. Family history did not help. I had an uncle on my mother’s side who was Type 1 in the 1980s, but I never knew my father or that side of the family at all. Given these unknowns the consensus is that my diagnosis was likely driven by genetics.

From a physical perspective not much has changed. I am around the same weight as before. I haven’t yet had any major health issues as a result, but these will become more likely as I get older. I have benefited from a recent development where I use a Libre monitor, which is a small disk inserted into my arm for 2 weeks at a time. This continually checks blood sugar levels and sends alerts if it goes too high or low. This reduces the need to use the traditional way of doing blood tests via finger prick tests.

How do I manage it on a daily basis?

Every human consumes and processes glucose by eating foods that contain carbohydrates. A non-diabetic whose pancreas functions normally will have a blood sugar level (referenced as HbA1c) of generally between 4 and 6.

I aim to maintain a level between 4 and 8 (the last 3 months have averaged 9). To do this I use a combination of insulins. I take “background” which is longer lasting and i use “fast-acting” to counteract any carbs that I eat.

This means that I need to estimate how many carbs are in my food and then take the according amount of insulin. If I eat something that contains 30g of carbs, I need to take 3 mmols of insulin i.e. /10. The insulin is then injected.

If I do not take enough, my HbA1c will be high, and if I take too much it will go low, both of which impact differently. Having high HbA1c is what causes long term issues like heart and eye problems. When it is low you feel terrible. The closest I can describe it is a feeling of impending doom. It is like your body telling you something is wrong, and action is required. This is where the common term “hypo” comes from, where sweats, disorientation and confusion happen.

In my CEO role, I am with clients and Agenor colleagues regularly. As such I must ensure that I have my fast-acting insulin, and some glucose sweets for if I feel my bloods are going low. I need to be constantly mindful of my carb intake.

Final thoughts

My diagnosis of Type 1 has had an impact on me. I generally manage to deal with it, but it requires close management every day. Some days are better than others. I still do most of the things I enjoy, but need to consider how things impact me and have therefore made some adjustments.

In my role as Agenor CEO, I have a great team. If during work I need to take a break to deal with a health matter they are supportive. I don’t talk about my condition much, so most people I meet don’t know I am Type 1 until I do something that shows I am.

I will continue managing it as best I can. I will take this opportunity to stress my admiration for the NHS. Since my diagnosis they have been superb and provide great ongoing support. I am very thankful to them.

I hope people find this useful. I know this is only one of many health conditions that impact people. I would be happy to have a chat with anyone who would like to discuss this further, or even look for a bit of support if they are experiencing health issues of their own. Please reach out to me at Gary.Montgomery@agenor.co.uk if you would like to have a chat.

Thank you.