As far as I know, there aren’t any restrictions with doctors/surgeons now. I know a T1 resident doctor who is a pumper and he hasn’t had any issues.

I also know that freight drivers don’t have any restrictions. However, a friend’s diabetes came into question when he fell asleep at the wheel once and caused a truck write off!

I have always been told that legally there can’t be restrictions imposed on T1’s finding employment in certain fields based on basic human rights but I do recall back in the 90’s being told that T1’s would not pass the health checks for entry into the navy or airforce.

When My Mr 10 was recently diagnosed he got some info from the hospital which said in NZ he couldn’t be a police officer or a member of the armed services but the paediatrician thought that someone had challenged that recently.

I think it comes down to “if you go low, might people, or even yourself, die”, and if the answer is yes, then the law says no.

This of course all goes back to “the olden days” when we did not have the tools we have at out disposal now to provide better management of diabetes. Unfortunately the law has not caught up, and realistically, I doubt there is the motivation for it to do so (as far as the politicians would think, “don’t fix what’s not broke”).

That said, I (reluctantly) admit that there are some jobs which simply ARE not suitable for a T1. Air Traffic Control being probably at the top of the list, if a controller has a sneaky low, and let’s face it, over their career even with the best of intentions and most careful testing, it’s bound to happen, then REALLY bad things could happen due to potential cognitive dysfunction before they notice – passing out would be better, at least somebody else would step in, but if you are subtly messing it up, things can get bad quick.

Recreationaly however, I see no good reason for many restrictions, which serve primarily to protect myself, from myself, if I should want to put myself “in danger” by flying a general aviation aircraft solo, or driving a house bus around the place (pretty sure that is verboten too), why should these things be disallowed, particularly with an agreed testing regime in place.

NB: Driving fitness for us is defined in the LTSA document below:
http://www.nzta.govt.nz/resources/medical-aspects/4.html

Class 2, 3, 4 or 5 licence and/or a P, V, I or O endorsement = Generally considered unfit to drive

But exemption is possible with strict conditions, “in exceptional circumstances” [which probably means, if you are dx and would lose your job over it then they will look more favourably]

The only classes we are deemed “fit to drive” by default are 1 (light vehicles = car/van/moped/camper van/delivery van, basically stuff that doesn’t need a certificate of fitness, only a warrant) and 6 (motorcycle).

We can not get a Passenger endorsement, nor Vehicle Recovery (tow truck), Driving Instructor or Testing Officer (people who do licence tests).

Type 1’s cannot join the Armed Forces. If you are diagnosed while in the Forces, you usually get to stay but not in a deployable role.

I think it’s down to a combination of a few legal restrictions combined with a whole bucket load of common sense and self-responsibility / awareness. We grow up in a world that tells us we can do anything and be anything we want to, that diabetes shouldn’t stand in the way of living our lives. But realistically …

Regarding jobs involving driving the NZ Transport agency states:

“People with Type 1 diabetes are not normally allowed to drive taxis, heavy trade vehicles or passenger service vehicles. If you are in this group and you want to drive one of these vehicles, ask a diabetes specialist to write to the NZ Transport Agency (NZTA) on your behalf. The letter should be addressed to the Chief Medical Advisor, who will look into the circumstances and see if an exception is possible. Strict conditions would apply.”

As much as I’d like to have my piolts licence I know it’s not really proctical. Most of the time I sort my lows out fine – but what if I have one that drops me like a brick – or worse – I’ve got a “co-pilot” and I get combative if they say I’m not right and I don’t believe them? It’s not just a case of putting yourself in danger – but if you’ve got a reasonable amount of fuel on baord, you are literally flying a bomb!
You also can’t be a professional or commercial diver – again it’s safety reasons – you can now get a PADI ticket more eaisly, but being 10-15m underwater and going low isn’t really a good situation to be in!

I’m all for not being held back by my diabetes, but I have to say I think it’s only responsible to restrict us T1s from certain jobs. Having had lows while driving (a couple of really scary ones spring to mind where I didn’t realise I was low until I was INSANELY low, think not being able to see properly etc), I really don’t want the pilot of the plane I’m in or the driver of the bus I’m on to be a fellow T1 with wildly swinging BGs.

It’s a fine line though and probably a debate we don’t want to draw too much attention to (shhhhh!) because you can imagine some sort of crazy blanket ban coming down on us all restricting us from doing all sorts of things vital to living a normal life.

Tough one though eh. I mean, if I as a T1 don’t want a pilot to have the same condition because he would endanger loads of lives with a hypo, can I reasonably be angry if a parent of my child’s friend’s objects to me dropping them home after soccer practice?

Truth be told, when I was 17 going for my learners licence, they would not let me take the first test without a proven history of my diabetes management and a letter from my doctor stating that he thought it was appropriate for me to drive a car safetly. I think I had to send this info off to the transport authority or somewhere and had to wait in suspense for a reply from them to say I was allowed to drive a car!

Nic – I have to agree that all these ethical questions do come into account re a T1 flying a plane versus a parent looking after a T1 at a sleepover. However, I do think that most parents out there only need to know the basics and knowing you’re only a phone call away can help them through it too.

But sometimes these T1 topics do send us around in circles, huh!

I can confirm that there are no restrictions on being a doctor (including being a surgeon)
I think some jobs are common sense. It comes down to the reletive risk and the risk of potential adverse outcome following a hypo is far greater when flying a plane, driving a large truck or bus compared to driving a car.
During my work as a doctor I always have my tester, insulin and food on me. I chose not to be a surgeon due to the fear of being tied up in theatre unable to eat (but actually there is no reason why with careful management and preparation a diabetic can’t be a surgeon (I hope I got the negatives right here)

The thing that really incensed me at medical school (now over a decade ago) was that they would not let me do a skydive having told me they thought it would be ok – no risk to anyone else, minimal risk to me as they parachute is actually deployed on exiting the plane.

Should tie it up here
as ruth said these topics can send us round in circles.

@Nic & Ruth

As a T1 pilot, well, not for a few years for various reasons, but have been, and will be again at some point, I can say that being a pilot with T1 is not an issue, at least recreationally, owing to the fastidiousness of pilots, and the limitations we place upon ourselves. There are checklists for everything, and diabetes is just another item on mine.

You won’t get a T1 pilot (or bus driver, there probably are some, somewhere) who have “wildly swinging” glucose, because to have these privileges they must have good control and a lot of checks. Most T1 car drivers by comparison, probably wouldn’t even test before they got behind the wheel, I know I don’t unless I feel it might be wise given the time of day, how I’m feeling etc, most of the time, grab keys, go.

Contrast to flying, I am required to test before flight, with results within a range to give plenty of “buffer”, I’m required to test every hour during a flight, I’m required to test before landing if the flight is longer than an hour, I’m required to record these results, I’m required to carry glucose, if I have to use glucose – which is done before hypo – or if the reading is above the desired range, I am required to land at the nearest practical opportunity to get stabilised… you get the point. And all this is DONE, it’s not optional, it’s as essential as all the other checks done on the aircraft and oneself before committing aviation, that’s why pilots have checklists, there are so many things to check before during and after flight, and they all have to be done, no ifs buts or maybes, diabetes, just another one.

That said, I don’t entirely disagree with Nic. When it comes to carrying a passenger – this is something I have not done and I think about if it is something that I would do or not, I tend to lean to “not” because while I accept the undeniably increased (however small) risk I put myself in, I would hesitate to permit somebody else to accept the risk of flying with me even if they were fully aware of it.

Unless of course the passenger is a fellow pilot in which case I wouldn’t really see a problem, no different to my being their passenger, and I think few would say that could be reasonably restricted “combative” low potential or not (luckily, I don’t get like that, at least, I don’t think I do).

In a multi-pilot commercial situation (most air transport) it is not an issue, and has been proven not to be by the simple fact that, there are Type 1’s in the cockpits of airliners in at least Canada, and I have heard in the Air NZ domestic ranks also. Again, strict regime, and the fact that if it all goes pear shaped you do have the captain next to you who can take over. Realistically this is an option only open to people DX after they were already in the airlines.

As I mentioned previously, in NZ Type 1’s can fly microlights, these are light weight 1 or 2 seat sports aircraft, they can fly only in the day, in good visibility, and not over cities and towns, and not for commercial purposes.

Finally, healthy pilots have heart attacks and strokes and other sudden incapacitation too, just like everybody else The medical requirements reduce the frequency, but they can’t eradicate it – at least the Type 1 pilot sees his doctors for a checkup every year at least (probably 6 monthly in fact).

I had always wanted to be a police woman when I was younger…even did a days work experience when I was 14years old. Later that year I got T1 and my dream was over. I’m now a primary school teacher so completely happy with my profession. What I learned about the police force is…you can’t go into the force with T1 but if you get it while a police officer then you are ok.

RUBBISH! I’m probably more reliable, fitter and more intelligent than any police officer I know.

Since there is some talk about the law etc here, I thought I might discuss some of the sections of the Human Rights Act which deal with discrimination. There has also been some talk about ‘laws’ which prevent diabetics from working in certain jobs. I am not aware of those laws, but would add that if in a job there is a risk to the safety of the diabetic or other people because of the nature of that job, then a policy decision might be made by the employer not to employ that person and that might not be unlawful discrimination necessarily.

Under the Human Rights Act, physical disablity is a prohibited ground of discrimination, as is any other loss or abnormality of physiological function. I would class diabetes as either of these things.

Discriminating against someone in their employment because of their diabetes as a general rule is therefore unlawful.

However, there are exceptions to this in sections 24-35.

- crew of ships and aircrafts, BUT this exception relates to non nz ships/aircrafts (whatever that means!)

- the most applicable section relating to diabetics seems to be section 29:

29 Further exceptions in relation to disability(1) Nothing in section 22 of this Act shall prevent different treatment based on disability where—

(a) The position is such that the person could perform the duties of the position satisfactorily only with the aid of special services or facilities and it is not reasonable to expect the employer to provide those services or facilities; or

(b) The environment in which the duties of the position are to be performed or the nature of those duties, or of some of them, is such that the person could perform those duties only with a risk of harm to that person or to others, including the risk of infecting others with an illness, and it is not reasonable to take that risk.

(2) Nothing in subsection (1)(b) of this section shall apply if the employer could, without unreasonable disruption, take reasonable measures to reduce the risk to a normal level.

(3) Nothing in section 22 of this Act shall apply to terms of employment or conditions of work that are set or varied after taking into account—

(a) Any special limitations that the disability of a person imposes on his or her capacity to carry out the work; and

(b) Any special services or facilities that are provided to enable or facilitate the carrying out of the work.

So basically, if there is a risk of harm to ourselves or others and the employer can’t take, without reasonable disruption, reasonable measures to reduce the risk to a normal level, it will not necessarily be unlawful to discriminate against you because of your diabetes.

I have only looked at the Human Rights Act and haven’t considered any cases, and it is likely that caselaw clarifies what ‘without reasonable disruption’, ‘reasonable measures’, and ‘reduce the risk to a normal level’ all mean.