T1D and Demanding Careers: Learning from Real-World Experience

T1D and Demanding Careers:

Learning from Real-World Experience

There is no single, predictable way to manage T1D in a demanding career. The reality is far more complex. It involves constant adjustment, awareness, and the ability to respond in environments where pausing is not always an option.

What becomes clear through lived experience is that managing T1D in the workplace is not something that can be fully planned in advance. It is something that is learned over time, shaped by the specific demands of the work itself.

At the same time, one important truth stands out: T1D does not need to stop you from pursuing your dream career. It does mean that adjustments are necessary, and that flexibility, preparation, and self-awareness become essential tools rather than limitations. When those adjustments are in place, people with T1D are fully capable of thriving in high-demand, fast-paced, and meaningful careers.

Insights from Professionals in Unique and Challenging Careers

This idea was reinforced in a recent the webinar conversation with David Campbell, Peter Atkins, Scotia Brailsford, and Camille Vibert, where I had the pleasure of speaking with them about their experiences working in unique and demanding careers.

Each of their perspectives highlighted that success is not about working around T1D, but rather working with it. Their insights demonstrated that with the right strategies and support, T1D becomes something you integrate into your career, not something that defines its limits.

1. Building Stability Before the Workday Begins

In unpredictable work environments, meals are not always aligned with fixed schedules. Because of this, individuals often prioritize foods that provide sustained energy and stability throughout the day, such as meals higher in protein and fat, or smaller, more frequent snacks that help maintain consistency. Insulin strategies may also be adjusted in advance based on anticipated activity levels, reducing the likelihood of sudden highs or lows.

Camille Vibert, Alpine Ski Coach, emphasizes the importance of starting the day with stability:

2. Adapt Diabetes Management to the Job

One perspective that captures this reality comes from Peter Atkins, Retired Fire Services District Chief. His experience highlights that everyone’s diabetes management looks different, and over time you figure out what works best for you in the context of your own life and work demands:

3. Anticipate Your Needs for High-Pressure Situations

Over time, these lived experiences build deeper awareness of how T1D behaves within specific contexts. In situations where time, safety, and urgency take priority, individuals are often required to make quick decisions and adjust their management strategies in real time.

Scotia Brailsford’s work as a marine biologist illustrates this clearly:

4. Create a Portable Diabetes Management System

This is also where the concept of a ‘portable diabetes system’ becomes important. Rather than relying on access to supplies in a single location, individuals carry what they need with them and often keep backups in multiple places. Fast-acting carbohydrates, extra supplies, and discreet treatment options become part of a system designed to function in real time.

Peter Atkins speaks directly to this idea: “I learnt to keep a little kit on the vehicle… Sometimes, if we were being moved forward or something, I’d put it on my person to be able to have it with me.”

This kind of planning reflects how diabetes care is embedded into unpredictable work environments, where access to resources cannot always be guaranteed. The goal is not to prepare for every possible scenario, but to build confidence in one’s ability to respond effectively when situations change.

5. Understand How Your Work Environment Impacts Your Blood Glucose Response

Work environments also shape how blood glucose responds, often in ways that are not immediately obvious.

Camille Vibert’s experience as an alpine ski coach reflects this complexity: “I’m outside pretty much all day… Every new challenge you encounter shows up also in your diabetes… at 2,100 meters of elevation… I now need so much less insulin.”

What this reveals is how environmental and physiological factors can significantly influence blood glucose levels. Often referred to in research as the “42 factors” affecting blood glucose, variables such as elevation, temperature, stress, activity level, sleep, and emotional load interact in complex and dynamic ways.

Understanding these responses takes time and observation. Patterns emerge gradually through repeated exposure, and once recognized, they allow for more informed adjustments to insulin, nutrition, and monitoring strategies.

6. Learn to Recognize Post-Work Blood Glucose Patterns

It is also important to recognize that the effects of work do not end when the shift ends. Blood glucose responses often continue long after activity has stopped.

For example, after sustained physical exertion, blood glucose may drop hours later as the body continues to recover and restore energy stores. This is commonly known as a delayed low. At the same time, stress and adrenaline during a shift can temporarily raise blood glucose, even without food intake, followed by a sharp decrease once the stress response fades.

Because these effects can overlap, post-work patterns are often unpredictable. Fluctuations may result from a combination of physical activity, stress hormones, irregular eating, and inconsistent monitoring over long or demanding days.

7. Plan Ahead for Post-Shift Blood Glucose Changes

Post-shift lows are particularly common. As the body transitions into rest, it continues to use energy for recovery, which can lead to drops in blood glucose hours later, including overnight.

Planning for this phase is just as important as managing the workday itself. This may include having a snack before rest, checking glucose more frequently before sleep, or adjusting insulin with awareness of delayed physiological effects.

This approach reflects a shift away from rigid routines toward a more flexible and responsive form of management, one that aligns with the realities of the work being performed.

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Thriving in a Career with Type 1 Diabetes

Managing T1D in demanding careers requires more than knowledge. It requires adaptability, preparation, and a willingness to learn from experience.

These experiences demonstrate that while no two individuals or jobs are the same, common patterns and strategies emerge over time. With awareness and intentional adjustments, it is possible to navigate even the most unpredictable environments while maintaining both health and performance.

They also reinforce an important message: people living with T1D are capable of pursuing any career or goal they put their mind to. While managing T1D may require additional planning and flexibility, it does not limit a person’s ability to succeed in demanding, high-performance, or unconventional professions.

Ultimately, success in these spaces is not defined by perfect stability or precision. It is defined by the ability to respond, adapt, and continue moving forward in the face of constant change.

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I’ve created a free, downloadable two-page resource that summarizes the key points from this blog. You can access it here >