Once upon a time, good luck landing a lot of different jobs if you were a known type 1 diabetic. Today, things are looking a whole lot brighter. Wil reports...
Not that long ago there was a long list of career opportunities that were, simply put, not open to people with type 1 diabetes. Young T1s couldn’t look forward to growing up to be airline pilots, firefighters, or cops. Nor could they hope to be an astronaut, FBI agent, or a spy for the CIA. The door was shut and locked at the employment office for offshore oil workers, air traffic controllers, paramedics, prison guards, scuba instructors, and even flight attendants. Most commercial driving jobs were also need-not-apply for us: Over the road trucking, buses, and taxis.
Even the Army wouldn’t let us be all we can be.
I’m happy to report today that the times they are a changin', and that the list of career opportunities has never been better for PWDs.
Almost any job you can think of in today’s world is now potentially open to type 1s, with a few notable exceptions. More on those in a moment. But first, what changed? Who unlocked and opened the doors to so many career fields that were closed and locked for so long? Naturally, the American Diabetes Association’s legal advocacy efforts, coupled with the 1990 Americans with Disabilities Act, have played a huge role; but we also owe a debt of gratitude to the humble glucometer.
Yep, we are now so used to these small machines that test our blood sugar, that we sometimes forget that it wasn’t all that many years ago that people with diabetes were in the dark when it came to our blood sugar readings. Lows hit with little or no warning, making some jobs genuinely unsafe for the person with diabetes, their coworkers, and even the general public—and creating the wide-spread belief that we were ticking time bombs. Blood sugar monitoring, along with greatly improved therapeutics for blood sugar control, have changed the real risks, and along with them, slowly, the public perception of diabetes.
Most of the jobs on our list are now wide open. PWDs are everywhere in the work force, including police officers, fire fighters, and even FBI agents. And while rules vary from state to state, buses and taxis are now commonly driven by PWDs. Even over-the-road commercial trucking requiring a Commercial Driver’s License (CDL)—long a field barred to insulin users—is now open through the Federal Diabetes Exemption Program (although the process is described as “rigorous”).
And now that we have the next generation of glucose monitoring equipment in the form of Continuous Glucose Monitoring being widely adopted by PWDs and covered by insurance, the sky is the limit.
Sadly, I met that literally.
Because that seems to be the one place left we type 1s can’t make a living. In the United States, type 1s still can’t work as professional pilots or air traffic controllers. Both of these jobs require a high-level medical certificate from the Federal Aviation Administration (FAA), and for these upper level medicals—using the federal terminology—diabetes requiring insulin is “absolutely disqualifying.”
But there’s hope. Access to the sky is improving. It wasn’t that long ago that diabetes blocked new applicants—and licensed pilots who developed diabetes—from flying. Period. But now there are several different avenues that allow diabetic pilots (like me) and PWDs who use insulin and want to become pilots, to take to the air—just not for pay. So while commercial flying is still blocked, along with air traffic control careers, since 1996 insulin-using pilots have been able to fly for recreation or personal businesses in the United States.
Meanwhile, in both Canada and the UK, type 1s can work as commercial pilots, and these foreign pilots are permitted to enter U.S. airspace by treaty. Even more encouraging, in 2015 the FAA revised its medical policies to allow PWDs to have commercial pilot-grade medicals on a “case by case basis,” although if any have been approved yet, I couldn’t find any information on the case. But it’s a start.
And while the sky is still the limit, the place beyond the sky is even opening up to PWDs. NASA says it will consider people with diabetes for the astronaut program, on a “case by case basis” as well.
Meanwhile, the United States military remains one of the closed doors. But that’s improving, too. While they won’t let you sign up if you have diabetes, if diabetes signs you up once you are already in the military, at least you can now stay in, although your job may change.
So it’s not a bad time in history to have, and to work, with type 1 diabetes. Society is starting to come to its senses, one career field at a time, and more and more doors open every year. Plus, thanks to protective legislation, we can no longer be refused health insurance (at least for now), thus opening the door for type 1s to be self-employed, run a small businesses or to work as independent contractors.
But there’s one major hurdle left: We are still commonly turned down for individual life insurance policies, for no other reason than the fact we have diabetes.
That door remains closed, and—for now—pretty firmly locked.