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Type 1 diabetic

24 replies

Silverstar2 · 21/09/2020 19:59

So as the title says, I am type 1. Although not that old, I am close to 50. No other problems and fit and healthy. But I work in an educational setting and cannot social distance.

I am worried and confused about what this increase in cases, etc means for me. Back in March my work sent me home before lockdown, but now it seems I just have to get on with it.

Anyone else in this situation?

OP posts:
Jrobhatch29 · 21/09/2020 20:13

Not me, but my brothers girlfriend is type 1 diabetic and is a TA. It's not controlled very well either. She was sent home before lockdown too but she asked to return in June. She did more admin based tasks, resourcing etc but is now classroom based again. She isn't particularly worried but that's more her personality she's very chilled. I have another friend who is type 1 too, not the same but she leads a baby class and has returned to that recently. She's more anxious but loves her job and as she's self employed she's relieved to be back

Enoughnowstop · 21/09/2020 20:26

No, but as a teacher and the parent of a type 1 secondary aged child, I understand your concerns. When are you next due an appointment? Could you try and bring it forward to discuss with your consultant?

AbsentmindedWoman · 21/09/2020 20:30

What's your hba1c, time in range and the standard deviation on your numbers? They are important questions for your risk analysis.

If you aren't using Dexcom or Libre already can you get a Libre prescription from your diabetes team?

user1471530109 · 21/09/2020 20:35

Hi OP. I'm 40, type 1 (well.controlled-ish) and a teacher. My covid age is 68! Although if I lose 4lbs it will be 60 Hmm. I am scared. I'm wearing a mask a lot more at school but feel it's pointless tbh. I'm really hoping we are added to the shielding list and it's brought back in. I think the fact we don't 'look vulnerable' makes the whole thing difficult. But I'm not sleeping and I'm sure it's because of the stress.

user1471530109 · 21/09/2020 20:38

I haven't had an appointment for over a year and haven't heard from the team. They're normally pretty good so I'm assuming it's all covid related.
Feeling pretty fed up. People are so flippant about the whole thing and they just have no idea (for most) what it's like with the extra worry.

Namechange1665 · 21/09/2020 20:57

I'm 40 & a type 1 diabetic teacher. I asked my consultant what to do, he said I'd be able to work from home like type 1s in the NHS. I just had to get my union involved. Funnily enough that isn't the case.

We've had 5 cases at school so far. It's just a matter of time before I get it. I'm teaching wearing a mask. It isn't as bad as people keep saying and it should reduce my viral load.

I'm furious that we weren't on the shielding list. It is clear from the stats that we are at considerable risk. I feel like diabetes UK let us down by not fighting for type 1s to shield.

Silverstar2 · 21/09/2020 21:01

I inject, no chance of a pump, not on NHS at my age in my area. Good control, been doing it over 40 years now.

Just wondering what will happen. Long term sick pay perhaps if I stay home? It's just so unclear right now.

OP posts:
Racoonworld · 21/09/2020 21:09

Unfortunately unless type 1s are added to the shielding list then not a lot will happen. The general vulnerable group is huge so whilst schools are still open it's likely that vulnerable people will still have to teach otherwise there won't be enough staff. Shielding people may be allowed to stay home but there is far less of them.

AbsentmindedWoman · 21/09/2020 21:20

Good control, been doing it over 40 years now.

What are your numbers though? 'Good control' means different things to different people. Is it good control as defined by the frankly inadequate guidelines of under 7? Or is it closer to non-diabetic or pre-diabetic numbers?

Is your a1c a result of fairly steady sugars without big swings from high to low? Or is is a result of frequent lows balancing out highs?

Do you have any retinopathy (including background) which can give clues into your overall microvascular health? Any neuropathy?

These details matter in terms of assessing risk.

I think a Libre would be far more useful than a pump right now and you can get it almost immediately unlike pump funding which you say you couldn't get Sad Honestly this makes me so angry. Every type 1 should have the option of a pump and cgm, it should be an individual's decision if they want it or not.

gigglingHyena · 21/09/2020 21:22

Fellow type 1 here, it is scary watching the cases go back up, especially in schools. So many near me have already sent bubbles home and we're support to be in an area with relatively low numbers.

I had my review recently and it has reassured me a bit, from what the DSN was saying even fairly mild covid symptoms are causing people to need quite a bit more insulin so keeping testing and checking ketones is crucial. Theres a guide for how much to increase by, I can't seem to paste the link on my phone but if you Google covid type 1 sick day rules you'll find it.

frazzledquaver · 22/09/2020 14:30

@AbsentmindedWoman

Good control, been doing it over 40 years now.

What are your numbers though? 'Good control' means different things to different people. Is it good control as defined by the frankly inadequate guidelines of under 7? Or is it closer to non-diabetic or pre-diabetic numbers?

Is your a1c a result of fairly steady sugars without big swings from high to low? Or is is a result of frequent lows balancing out highs?

Do you have any retinopathy (including background) which can give clues into your overall microvascular health? Any neuropathy?

These details matter in terms of assessing risk.

I think a Libre would be far more useful than a pump right now and you can get it almost immediately unlike pump funding which you say you couldn't get Sad Honestly this makes me so angry. Every type 1 should have the option of a pump and cgm, it should be an individual's decision if they want it or not.

Whilst it's obviously good to have an HBA1C closer to target (6.5% not generally 7%), and it does reduce risk, it doesn't eliminate it. If the OP says they are happy with their control, then probably better to listen to what they are saying. Actually in the studies, it was a J-curve. Lowest HBA1C and low body weight were linked to higher mortality. So between 6% and 7.5% probably the best place to be.
AbsentmindedWoman · 22/09/2020 17:00

Whilst it's obviously good to have an HBA1C closer to target (6.5% not generally 7%), and it does reduce risk, it doesn't eliminate it. If the OP says they are happy with their control, then probably better to listen to what they are saying. Actually in the studies, it was a J-curve. Lowest HBA1C and low body weight were linked to higher mortality. So between 6% and 7.5% probably the best place to be.

Sure. I should have been clear that I wasn't demanding an answer to those questions. It's more that I would encourage every diabetic to ask themselves those questions when evaluating their risk.

I'd be very careful in making a statement as you have that "between 6% and 7.5% probably the best place to be" for covid. It is not a simple relationship. It is certainly not the best place to be for diabetics in general.

A1c by itself does not give enough nuanced data about overall blood sugar management. That is why I also asked about time in range and standard deviation - a1c is only really useful in conjunction with these. It is possible to have an a1c that looks great on paper but to have really wide swings, or a lot of hypos. In that case the a1c is dangerously misleading.

People with diabetes deserve as close to NORMAL blood sugars as possible*, to give them the best shot at better health long term. The lack of access to both the tools and education on how to achieve this ('normal' sugars, without many lows) really angers me. But I digress.

Covid can do significant damage to the vascular system, as can diabetes. The better shape you are in to begin with, the better your chances.

Agree of course that risk can only be reduced, not eliminated!

*as close to possible to normal sugars - not 'perfect' sugars, because that's not realistic - but a hell of a lot better than what is happening at the minute. The UK's stats on adolescent diabetics management are fucking depressing.

anniversarywoes · 22/09/2020 17:10

Dh is type 1 but also currently unwell with other 'things' that make him even more vulnerable to covid.
We have 2 teens at a large secondary school and I work in an environment where there is zero social distancing or ppe etc
We also live in a city that has high case numbers.
He is currently living elsewhere, it's shit and we miss each other terribly but I'm not prepared to risk it. He is able to wfh and interestingly his diabetic consultant felt our decision was the right one.
We feel type 1s have been massively overlooked throughout all this Sad

Silverstar2 · 22/09/2020 17:20

It just feels like a waiting game to see what happens really.

Take care everyone x

OP posts:
jellybeanz1212 · 22/09/2020 17:34

I'm 37 type 1 a1c 9% anaemic which lowers immunity etc... normal BMI worked full time throughout cleaning gross public toilets. Still ok 👌

SimonJT · 22/09/2020 17:35

I’m a type 1, I also have 20% spleen function. There were murmurings about the spleen causing shielding, but it didn’t. I do tend to catch colds etc fairly easily, but I’m not ill for very long and I’m rarely ill enough to take a day off work etc and I’m not reliant on daily antibiotics.

I was surprised that type 1 diabetics weren’t added to the shielding list when it became obvious that we had a worse outcome compared to type 2s. Especially as type 2s often have comorbidities, typically older etc.

I’m not hugely worried, but I’m not completely relaxed either, plus stress would damage my levels. My control is very good and steady, spikes are very rare for me. I’m also very active (semi professional sports player) which slightly reduces my risk. I also have a very good diet, by which I mean I don’t listen to the absolute shit advice I’m given at the diabetes clinic!

When I was assessed at rugby my covid age was 72! My main employer haven’t bothered looking at covid ages and have asked staff who have gone back to the office zero questions about their health. Ironic considering its an insurance company...

I have been careful, apart from rugby I only mix with minimal people outside of my household, they’re people who have also been fairly cautious. My little boy is at school, children are disgusting so him bringing something home is fairly likely. He bought a cough and temperature home after five days at school Hmm

I think all we can do is look after ourselves physically and mentally, be generally sensible and wait and see if advice changes.

user1471530109 · 22/09/2020 17:36

Has anyone got any links? @AbsentmindedWoman and @frazzledquaver you sound like you've read something specific?

I agree regarding hba1c and not necessarily meaning tight control. Mine is 7.2 but since back at school the swinging about is happening and I'm struggling again. The libre helps but teaching definitely gets in the way. I'm sure stress is having an impact too.

Has anyone actually had a face to face with their diabetes team? I haven't heard from mine apart from letter at the beginning of lockdown reminding me of sick day rules etc.

AbsentmindedWoman · 22/09/2020 17:37

We feel type 1s have been massively overlooked throughout all this

Yeah, this. I'm not in the UK anymore but are T1s being added to the shielding list?

Sending solidarity to all my fellow diabetics and their loved ones.

PeaceAndHarmoneeee · 22/09/2020 17:42

I was so worried about DP when Covid kicked off - he's t1 diabetic and 50.

And unfortunately in April he bloody got Covid (confirmed by test). But he was absolutely fine, it was like a mild version of flu for him, a few days on the sofa and he was fine again. I was far far more unwell then him and I'm a fit, healthy younger and non diabetic person!

Just posting to hopefully show that T1 diabetes does not always = bad Covid experience

Endofmytether2020 · 22/09/2020 17:49

@user1471530109

Has anyone got any links? *@AbsentmindedWoman and @frazzledquaver* you sound like you've read something specific?

I agree regarding hba1c and not necessarily meaning tight control. Mine is 7.2 but since back at school the swinging about is happening and I'm struggling again. The libre helps but teaching definitely gets in the way. I'm sure stress is having an impact too.

Has anyone actually had a face to face with their diabetes team? I haven't heard from mine apart from letter at the beginning of lockdown reminding me of sick day rules etc.

This is probably the most comprehensive analysis. www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30271-0/fulltext
SheepandCow · 22/09/2020 18:00

Don't know if this helps at all but the UK seems to have interpreted data differently from other countries, who have flagged type 2 as the biggest risk. Not that type 1 isn't necessarily an increased risk, just that it might not be quite as high risk as type 2.

Here's the US Center for Disease Control list of highest risk conditions. You'll see type 2 on that list (with type 1 on the next list down).
www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

Until we know more it might be sensible to have all diabetics on the shielding list, just to be safe.

jellybeanz1212 · 24/09/2020 17:38

Thanks for sharing @PeaceAndHarmoneeee glad you're husband was ok us type 1s are made of thought stuff Wink

Koalabrush · 24/09/2020 19:23

I’m t1, mid 30s, slim, a1c is 6.5% - I’m about 52 in covid years.
I’m feeling fairly down at the moment so I don’t care too much if covid ‘gets me’ but I do think t1s should have been shielded.

jellybeanz1212 · 24/09/2020 19:42

I've worked throughout mid 30s slim a1c is high 8.9 also have anaemia which lowers immune system have worked in a busy train station where the public don't seem to care for social distance. Still ok 👌

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