How's the sugar patient's life

Living with diabetes

Diabetics can often lead a largely normal life if their blood sugar is well controlled, but they should still observe a few things in everyday life:

Physical activity

Physical activity can have a positive effect on your diabetes, as exercise lowers blood sugar levels and increases the body's sensitivity to insulin. In addition, physical exercise stabilizes your body weight, trains the cardiovascular system and prevents circulatory disorders.
The prerequisite for this is that you are physically active at least 5 times a week for half an hour. Sports particularly suitable for diabetics are endurance sports that stress the cardiovascular system, e.g. B. jogging, Nordic walking, walking, cycling, hiking, swimming, cross-country skiing. Motor sports, diving, paragliding or other sports in which you can endanger yourself and others in the event of hypoglycaemia, however, should not be practiced.
Although examples of diabetics who practice high-performance sport as professionals show that successful competitive sport is possible even with diabetes, diabetics should not exhaust themselves completely. A good rule of thumb is not to exceed a pulse rate of 180 minus the age in years. This corresponds to about 50% of the maximum performance.

As a diabetic, you should be able to measure your blood sugar at all times and, if necessary, regulate it. Therefore, you should always have the following aids with you when exercising:

  • Blood glucose meter / test strips
  • glucose
  • Additional sources of carbohydrates: bananas, granola bars, isotonic drinks
  • Glucagon
  • Fast-acting insulin (if intensified insulin therapy is being used)

You should also have your diabetic ID with you, with instructions on how you can be helped in the event of low blood sugar (hypoglycaemia). Before deciding on a sport, discuss this with your doctor. Exercise is not always advisable, especially if you suffer from diabetes-related diseases. Patients with nerve damage, increased blood pressure or diseases of the coronary arteries should only exercise to a limited extent. In addition, weight training is not recommended in the event of eye damage.

Because exercise lowers blood sugar levels, it is important that diabetics avoid hypoglycaemia. You can do this by reducing the dose of medication or insulin, or by consuming more carbohydrates. For every hour of moderate activity, you need 1-2 additional bread units (BU) in the form of glucose, beverages or fruit. If you want to do sport as a diabetic, you should definitely measure your blood sugar before, during and after exercise. If your value is below 100 mg% or above 300 mg% before exercise, you should definitely not be physically active.

job

Thanks to the treatment methods available today with flexible blood sugar adjustment and control, diabetics can now practice the profession of their choice, with a few exceptions. On the other hand, diabetics on insulin or sulphonylurea treatment may be restricted in their choice of occupation as they are at risk of hypoglycaemia. You should therefore not engage in activities that could endanger yourself or others in the event of sudden hypoglycaemia. This includes:

  • Working with a risk of falling
  • Professional passenger transport
  • Responsible monitoring function
  • Professional use of weapons

The guidelines for employing diabetics in the public service and in the operational service of Deutsche Bahn are also based on this principle. For example, diabetics at risk of hypoglycaemia are not allowed to carry passengers on trains or public transport. Diabetics, whose metabolism can be adjusted solely through a healthy diet, are basically allowed to carry out any activity they would otherwise be suitable for.

Despite this fact, diabetics can be classified as severely disabled. The Federal Ministry of Health and Social Affairs assigns type 2 diabetics to different degrees of disability, depending on which drug therapy is used in addition to the correct diet to adjust blood sugar levels:

  • With oral anti-diabetic drugs that do not cause hypoglycaemia (e.g. alpha-glucosidase inhibitors, biguanides, glitazones, SGLT2 inhibitors, DPP4 inhibitors): 10% disability
  • With sulfonylureas: 20% disability
  • With oral antidiabetic drugs and supplementary or sole insulin injections: 30% disability
    Difficult to adjust with insulin: 50% disability
  • Diabetics who, on the basis of a medical report, are considered to be between 30 and 50% disabled can be treated on an equal footing with severely disabled persons if they cannot find employment otherwise as a result of their disability.

Road traffic

In road traffic, too, the risk of a sudden low blood sugar level determines the assignment to different hazard groups. Diabetics can drive unrestrictedly if they take biguanides, SGLT2 inhibitors, DPP4 inhibitors, alpha-glucosidic inhibitors or glitazones in addition to their special diet. Driving license applicants also have to meet certain requirements. Diabetics who are at risk of hypoglycaemia are subject to certain restrictions. Truck, taxi and bus drivers are not allowed to inject insulin.

Driver's license validators with diabetes must present a certificate from their treating doctor stating the type of diabetes, the quality of blood sugar control, the frequency of self-checks and the risk of hypoglycaemia. However, there is no obligation to report retrospectively if the illness only occurs after the driver's license has been acquired.

Diabetics should have their general condition and, above all, their eyesight checked regularly. The latter can be particularly impaired by a diabetic retinal disease.
As a diabetic, you should also consider the following:

  • Test your blood sugar level before long car journeys. If it is too low, you can prevent hypoglycaemia by consuming carbohydrates.
  • Before driving, never inject more than the usual amount of insulin and strictly adhere to the prescribed time of day.
  • Eat a little more than too few carbohydrates before driving
  • Maintain your eating habits even while driving. Take prepared snacks with you in the car and take an exercise break every two hours and consume carbohydrates.
  • Do not sit in the car if you suspect that hypoglycaemia is beginning or waning.
  • Always keep glucose close at hand while driving.

to travel

Well-adjusted diabetics can go on trips if they make sure that their metabolism does not derail even when they are on vacation. Since one is usually more physically active on vacation, more carbohydrates have to be consumed or less insulin injected. Heat and sunbathing can also accelerate the action of insulin.

Also, keep in mind that insulin becomes ineffective at temperatures above 40 ° C. It is best to transport your insulin in hot countries in a cooler bag, thermos or a styrofoam container. If the temperatures are below this mark, you can definitely carry the insulin in the car or in your backpack if you avoid direct heat or sunlight.
Also remember to take your diabetic ID with you on all trips.
The following list can help you pack your memories as a reminder:

carry-on baggage

  • Insulins, blood sugar lowering tablets
  • Syringes, pens with spare needles
  • Test strips for blood sugar, acetone, urine sugar
  • Meter with spare batteries
  • Lancing device
  • Diabetes diary
  • glucose
  • If necessary, glucagon
  • Diabetes ID with translation into the national language
  • Certificate for controls at the airport or at the border
  • Snacks between meals

Main baggage

  • Supplies: insulins, blood sugar lowering tablets
  • Insulin vial in case the pen is defective
  • Test strips for blood sugar, acetone, urine sugar
  • glucose
  • Carbohydrate exchange table
  • Possibly sweetener