| Editor’s note: The NVFC’s second annual National Firefighter Health Week comes to a close Friday with a focus on diabetes. In the following article, Tim Hoy, of the London Fire Brigade, talks about his campaign to raise awareness of the condition within the fire service and offers advice on living with it. |  |
By Station Officer Tim Hoy, London Fire Brigade
Founder of the International Register of Firefighters with Diabetes
 Tim Hoy is in charge of his own watch at Finchley in North London. |
It’s almost 20 years since I was diagnosed with type 1 diabetes after a short but promising career with the London Fire Brigade. At that time, insulin-treated diabetes was absolutely proscribed for operational firefighters, so my future looked pretty grim back in 1989.
One of the very negative aspects of my little bit of diabetes knowledge at that time was the fact that it was based on the first aid/EMT perspective, so it was all “worst case scenario” stuff. Without knowing too many people with the condition, my assumption was that there was a tangible risk of me suffering a severe low blood sugar (hypoglycemia) episode at work. Clearly wearing breathing apparatus, commanding hazmat incidents, climbing ladders and driving fire trucks required me to be conscious, and having diabetes conflicted absolutely with that requirement — or so I thought.
Thankfully, my education about this wholly controllable medical condition was facilitated within the first few weeks after diagnosis by the expert medical team at the Diabeticare Centre at Hillingdon Hospital in West London.
Challenging rules
My previous prejudices were overcome as I learnt of other people with diabetes who had triumphed and proved that with the right motivation and knowledge they could do just about anything without losing control. The task that lay ahead was taking on the rules set by the government’s Home Office, our employers in the fire service back then.
I was reinstated to unrestricted operational duties in April 1991 and am now in charge of my own watch at Finchley in North London in a rank that roughly equates with that of Captain in the United States.
This is very mush an abridged version of events and the full history is contained within the International Register of Firefighters with Diabetes (IRFD) Web site that can be found at Irfduk.net, which contains a great deal of self help information and advice for the newly diagnosed.
As a direct result of our campaigning, there are now 361 people back at work and numerous others who have used our case law to make their own arguments. There are now branches of the IRFD in Canada, Australia, South Africa and the United States, the latter being headed up by the legendary Paula Heule in Colorado Springs.
Diabetes can of course do incredible damage if not properly managed. In the UK alone, more than 50 percent of people over the age 50 who are blind have lost their sight as a result of diabetic retinopathy. And diabetes remains the third largest killer in the United States, so whilst the possibilities are endless for what you can do after diagnosis, this has to be balanced against the prognosis if you don’t know how to or cannot be bothered to look after yourself.
Another absurd but commonly held view is that diabetes treated by tablets or diet is in some way a “mild” form of the condition. For people without access to regular health checks, it is possible for them to have had type 2 diabetes for as long as 10 years before they are diagnosed. By the time they learn they have the condition, they may already have complications from it such as retinopathy, cardiovascular or kidney disease.
It’s easy to be frightened about the prospect of an early and painful demise because you have the dreaded diabetes, but like the potential for workplace hypoglycemia none of this scary stuff is a foregone conclusion. There are six simple rules that should ensure you have a full and active life after diagnosis.
1. Take regular exercise
2. Eat healthily
3. Don’t smoke
4. If you drink alcohol, do so in moderation
5. Regularly check your blood glucose levels and
6. Adjust your doses of insulin, tablets or diet to ensure blood glucose levels are within the “normal” range
The first four of these rules are ones you will have undoubtedly already heard whether you have diabetes or not. Similarly, a healthy “diabetes” diet is actually just a healthy diet. That is a diet which is low on saturated fats, sodium, cholesterol and refined products and one that is high in fiber. Eating fresh fruit and vegetables is not an exclusive activity for people with the condition, but recommended to anyone who desires a healthy and long life.
It’s easy to become depressed about diabetes and how it can affect us, yet after almost two decades with the condition I remain the luckiest and happiest person I know.
As I write this, the Beijing Olympics are in full swing, but in four years time some of the world’s fastest and fittest athletes of 2008 will have been beaten by the next generation of Olympians in my home city of London. In short, there will always be someone better off than you and many who are significantly more disadvantaged than I am by this inconvenient medical condition.
It is entirely possible to lead an active, happy and full life with diabetes. For me, the most important thing in this regard is to ensure I control my condition rather then let it control me. Ignorance remains our greatest enemy and education is the greatest weapon to defeat it.
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Tim Hoy set up the International Register of Firefighters with Diabetes to support the rights of those in the fire service with the condition. He has now expanded the group’s work after learning of the discriminatory difficulties people in many other occupations were suffering. For more details, visit Irfduk.net.