How I manage diabetes at work
One of the most common questions I get is how I manage diabetes while I am on console in mission control. The logistics can really be applied to almost any high-stress job, so I thought I would share what works for me!
Preparation
Being prepared is just a baseline requirement for living with type 1 diabetes. Before each shift, I go through a checklist of backup supplies that includes: a full site change, insulin vial, insulin pen + needles, glucose monitor, lancing device and test strips, charger, and fast-acting glucose. I'm at the point where I have this checklist memorized, but I don't think there is any harm in actually printing out a copy for yourself.
Part of my preparation step also includes alerting the Flight Director (the leader of mission control), that I have diabetes. I have always had good luck being open and honest about my diagnosis and would rather get any questions or conversations over before something happens.
Another piece to my shift preparation is adjusting my baseline blood sugar level. While I normally aim for 100 mg/dL, I like to run ~125 mg/dL while on console (this is just how I manage, ask your doctor what makes sense for you!). Since I experience a rapid drop in blood sugar with the onset of adrenaline, keeping that blood sugar up gives me more runway should an anomaly occur.
Snacks and meals
I like to reduce the number of variables I'm dealing with while on shift in mission control. One of the best ways to do that (for me, anyway), is to pack snacks and foods with very precise carbohydrate counts that I am familiar with. Yes, this does mean a good bit of prepackaged or low-carb foods, but it also means a smoother trendline, fewer corrections, and a decreased chance of going low.
I also like to space out my food intake during my shift, just another attempt to keep that trendline a little more steady!
Scan pattern
As flight controllers, we refer to the path we take when watching our data as our "scan pattern". I usually look at our digital display first, zeroing in on the parameters we often see anomalies, then going over the entire display. Next, I move on to our illustrative display, just checking on the status of each of my pieces of onboard equipment, and finally, I move over to the plots for a quick check of long-term trending data.
It's important to incorporate blood sugar data as part of my scan pattern. In general, I have my CGM limits set pretty tight just to give me a little nudge before things start reaching a level of concern. I also use periodic satellite handovers as a muscle-memory cue to check my blood sugar. These handovers happen fairly frequently, around every 30 minutes or so. Finding a periodic cue to check your blood sugar is probably my number one tip!
Contingencies
We've already discussed preparation, but what happens when something unexpected happens, diabetes-related? First - stay calm!! Yes, it's important. Next, give yourself credit because you have probably already considered and prepared for something like this! There are always workarounds. Sometimes they are cumbersome, but there are always options. Remember, you can't perform well at your job if you or your equipment aren't well!!