Help! Career Advice for a Fellow T1D?

Hi all,
I have been type 1 since February 2011, diagnosed midway through law school at the ripe ol’ age of 22. I finished law school, passed the bar, and am now a prosecuting attorney (4 years in January).

From November of 2015 until last September, I was in a position that I loved and excelled at (prior to that I was in a stressful position that made me want to leave my job, as it gave me blood sugar issues). In September, I took advantage of a job opening in my office that is by definition far more stressful than most jobs (special victims prosecutor). It was a big leap for me, totally outside of my comfort zone, but I figured that since I am now more experienced with diabetes than I ever have been, I would be able to cope.

It’s been about 5 months now, and I am struggling. While my blood sugar management and knowledge is better than it has been (A1c is 5.5-6%), the new role is taking its toll on me. I am in a constant state of stress and worry about my cases, which not only leaves me drained on its own, but has led to an increase in lows while I’m sleeping and bad night sweats. During the day I’m tired, and after work/on weekends all I want to do or can do is sleep/try to recuperate to have energy for the week.

I talked to my old supervisor about switching back to my old job (a monkeywrench being that my new position typically carries a 2yr commitment and it’s only been 5months), and she said she would be okay with it. She brought up some points that I think are valid:

-is it the newness of the role/stress that is causing my issues, and will that go away in a couple months? My response is maybe, but even if it is, I am not sure if I can handle feeling so exhausted and crappy until I figure that out

-did my diabetes get worse, which is impacting my job, or is the job impacting my diabetes? The second, because before that I didn’t have these issues

-am I copping out? Well…am I? I am still trying to come to terms with the fact that T1D is a disability and by definition disables me, so even when I want to do things, I am limited. Recognizing those limits is difficult.

So my issue is that I am having trouble explaining this chronic illness to healthy people because they do have valid questions and alternative hypotheses, but inside I am just screaming “this job is making my control harder and my life more tired, please just accept how all-encompassing my disease is”. Not to mention, other diabetics at my office (T1 and T2) “handle” it better/differently than I do, which I know will be another basis for the question of what is motivating me. Of course, I am always wondering if it’s legit or just me being a wimp when I feel these limits…but maybe “being a wimp” is sometimes necessary to respect the disease. After all, a job is not worth damaging my health – physical or mental. Has anyone else dealt with any of this? Any advice? TIA.

TL; DR: new role at work is more stressful and causing me to have new/different/overwhelming issues with diabetes and I don’t know how to express this or handle it best.


I have a friend who works in the careers industry and she has recommended Rosalind Joffe, who has been a chronic illness career coach for years

Wishing you the best!

Welcome to our community!


You are a young professional with a job that I imagine would be tremendously stressful and challenging for anyone in your shoes.

Diabetes is hard and stressful. Your job is also hard and stressful. Don’t let yourself fall into the trap of thinking that either is hard because of the other… that’s a self defeating mechanism.

Those other diabetics that “handle” it better than you might be looking at you and thinking the same exact things you’re thinking about them.


Hi Knitigator -
I’m not a Dr. but have you looked into a physical cause for how you are feeling, some vitamin deficiencies like B12 can cause anxiety and change in sleeping patterns. Other medical issues - even our stupid hormones can cause night sweats and don’t forget low sugars as well.

I say, see your doctors - several of them before you give up on a role you seem to be excited about.

FYI - I believe that fatigue is highly under valued as a symptom by many of our Dr. I pressed to have mine understood and found out that I have a condition that causes it…

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Hi -

I am a CPA who was diagnosed in January 2007 with T1 at the age of 57. Let’s just say that first tax season did not go very well although there were no disasters. My response to getting sick was to drop about 20% of my clients over the next year or two and restructure my work life and schedule so that they put less stress on me especially during tax season. I had that option because I have my own practice.

A friend told me about a friend of hers who was diagnosed in her thirties who went from 5 to 4 days per week after diagnosis.

It’s all fine and good to pump up your chest and say that I can do anything with diabetes but the reality is that even when well controlled - and your A1Cs are great even taking into account your lows - diabetes takes a lot of time and mental energy. Only you can tell whether you should cut yourself some slack right now.

Over the years I made adjustments and built my practice back up. Making a decision to step back from a very stressful job right now doesn’t mean that you’ll never be in line for a stressful and rewarding job in the future.



@Knitigator, your A1c is terrific, congratulations! And you should be very proud of what you have accomplished so far in your career too. This is such a tough challenge you face. I spent 25 years managing and launching start-ups in Silicon Valley, a very high stress kind of a job with enormous numbers of hours per week - I think probably similar to yours in stress and hours. It was very enjoyable but also very stressful.

I now have a T1D son who was diagnosed last year, almost a year ago. I have a hard time imagining doing both at the same time - treating my son and doing the job I used to do. Of course, you know your D better than we know his, because my son was not diagnosed so long ago - so I am sure it takes you less time, work, and energy.

A lot of the stress in such a job has to do with newness.There is no doubt that a couple of years in a new, tough job, make an enormous difference in both your comfort and your stress level. So, I am certain that in another year and a half your level of comfort in your job, and therefore your stress level, will be radically different.

But is the lower level of stress going be be compatible with long term care for your diabetes? That is pretty hard to determine.

So, while I cannot advise you as well as others in this forum, since I am not a long-time T1D myself, one suggestion I would have for you would be this:

  • fix yourself a deadline by which to make this decision, (a) by which time you feel you will have a good feel for your job and (b) until which you think you can last. I would suggest no less than a year from when you took your job. The best would be two years in the job, but that is too much to ask.
  • by then, you should be much more comfortable in your new role. If you feel, at that time, that it is unreasonable to bear both stresses, then go for another option.

I can understand how, for us guys, it is psychologically hard to decide to quit on a challenge. But YDMV - your diabetes is what it is, and is different from everyone else’s. Nobody can know the burden it brings upon you but you. If you can, give it a few more months to make sure you have gotten over the worst of the learning curve - but if you can’t, you should NOT ever feel bad about that.

I wish you a lot of luck in your decision. If you’d like to talk, PM me and I’ll gladly chat on the phone for as long as you want. Not sure where you are, btw. We are in SE WI.

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Hi Knitigator. Just for perspective… I’ve been a T1 for over 50 years; I’ve been a CPA for 36 years. I’ve been a forensic accountant and expert witness for the last 17 years; this is a very demanding role in a very demanding “industry” (the legal system), and cases, as you know, simply consume all the hours there are between assignment and trial date. I have NEVER been unable to perform the job… and I’ve suffered plenty of highs and lows during the analysis phase through trial prep and trial itself. While it is important to keep your T1 under control, it is possible to do both. The stress of the job never affected my BG levels, though scheduling issues often did - but I learned to simply adjust for those. The difference between us is that I was dx’d at age 11… so by the time I went to college, I’d had about 7 years to adjust to the management of my T1. You’ve not yet reached the experience level I was at in high school, so you’re at a disadvantage. But you CAN learn to get your T1 under control and still manage your law career… but as Maurie observed, it is possible to take a step back in your career, and then ratchet it up again when you’re more comfortable with the T1 management… which, for me, has become so second-nature that I give it very little thought, and can focus on my work. With over 50 years of managing T1 behind me, I suffer NO serious complications (I do have trigger finger) and have every intention still, as I did when I was dx’d at 11 yrs old, of dying of something far more interesting.

AND… be sure to talk to your doc. Not all the symptoms we suffer are caused by our T1. I had a seizure at work several years ago (in office, not at trial), and the ER doc wrote it off as a low episode… but a year later, and another seizure, and a much smarter doc did a brain scan… and found a five-year-old tumor that had caused both seizures. I shouldn’t have accepted the first ER doc’s conclusion (which didn’t make sense to me at the time, but arguing got me nowhere).

Good luck - and keep up the good work on your BG management.



Hi @Knitigator, Everyone here has offered very good suggestions.

One thing I’d also add is that the specific types of cases you’re handling could also be taking their own toll, separate and apart from the demands of T1D. I was a volunteer rape counselor for a brief while and I definitely internalized some of what I heard and felt it in my body in the form of constant stress, anger and worry, which did wear me out.

I’m not sure what the answer is (I wound up having a kid and having no extra time for that, so I never did figure out a long-term solution). But perhaps a psychologist or psychiatrist could suggest ways to stay engaged with your work without taking the worry and trauma home with you. Obviously that takes time, which is in short supply, but finding some way to decompress is key over the long haul, I’d imagine.

Also want to note that while it may get easier (and probably will), it’s also okay if managing your diabetes and working such a demanding job is too much for you. It’s taken me a long time to recognize that, for instance, my mom just doesn’t have the same level of stamina as me, and that mine is worse than some of my friends’. That’s part will power and practice, but also part biology and there’s no shame in deciding what your limits are and working within those to protect your health.

Good luck, and congrats on the fabulous A1C!


T1D and stress???

How about being Theresa May - she has to visit Donald Trump next week and deal with Brexit!

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I’m T1 for 35 years and held a number of different schedules in my job. While my job title doesn’t necessarily change my exact responsibilities and the exact hours I work has changed a couple times.

How I feel about my diabetes and level of control has changed drastically without my control actually changing very much.

Mostly my A1C has been in the high 5’s or low 6’s. The ONE exception, was when my job had me driving multiple times every single day for a few months and I kept my bg’s high to avoid risk of a hypo, and I had an A1C of 7.4. Since then I make a conscious choice to not go on any assignments that require frequent driving for work.

I’ve been in a similar place to you, with an increase in hypos without any big apparent reason. It can be hard to do it but sometimes it really is best to just back off a notch in your effort at keeping all numbers low and accept an occasional high number or a slightly higher average.

I do find a busy job at work will often have me just reacting to reading-to-reading bg’s and not thinking about the longer term trends and adjustments.

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Well, you’re a special victims prosecutor, which means you are absolutely not a wimp, by definition. To me, it sounds like you might need to do some value balancing: you state that a job isn’t worth your health, but earlier you say that this is both an amazing opportunity and something you value highly. This leads to a couple of questions:

  • Can you handle a slight impact on your immediate health (it probably won’t affect long term unless you get totally out of control) in order to fulfill the two year commitment?

  • Will persisting in this job open up less stressful long-term options that would (or might) hit the “sweet-spot?”

  • Are you making other quality-of-life sacrifices (beyond stress and BG control) for this job, that when taken in aggregate make it a losing proposition (family commitments, travel, additional schooling, leisure activities, etc.)?

  • Are there any diabetes-management treatment strategies you can consider implementing that might lessen the impact of stress on your BG (exercise, lower-carb diet, pumping + CGM, meditation, etc.)?

I’m just posting these because they are things that I think about a lot. I have a young family, am in a highly stressful postdoctoral fellowship, worried about future career opportunities, etc. Probably not nearly as stressful as being a SVP, but I have a lot that weighs on my mind. I’ve found that increasing my exercise, practicing meditation, and doing some counseling have dropped my stress (which seemed unmanageable a year ago) to totally manageable levels. But that’s me, and YDMV.



I cannot thank everyone enough for your feedback and input–it’s given me so much to consider and a lot of great context for my decision. And thank you for sharing your own stories, struggles, and triumphs!

This community is refreshingly supportive and it makes having T1D more manageable knowing I’m not alone.


I don’t know why should diabetics be considered disabled?? I don’t mean to offend anyone, just doesn’t make sense to me

I think because there is a physical impairment that substantially limits your ability to do some things some of the time. And the fact is, you would need some accommodations at least some of the time in most jobs – like being able to eat something to bring your sugar up if it’s too low, or taking a break to inject insulin, etc.
Here’s how the it’s laid out for a government employment commission here in the US:

As a result of changes made by the ADAAA, individuals who have diabetes should easily be found to have a disability within the meaning of the first part of the ADA’s definition of disability because they are substantially limited in the major life activity of endocrine function.9 Additionally, because the determination of whether an impairment is a disability is made without regard to the ameliorative effects of mitigating measures, diabetes is a disability even if insulin, medication, or diet controls a person’s blood glucose levels. An individual with a past history of diabetes (for example, gestational diabetes) also has a disability within the meaning of the ADA.10 Finally, an individual is covered under the third (“regarded as”) prong of the definition of disability if an employer takes a prohibited action (for example, refuses to hire or terminates the individual) because of diabetes or because the employer believes the individual has diabetes.11


Oh okay, I see, thank you for reply. I don’t get the physical impairment part, though? Unless somebody has developed some complications already (but those should be treated on their own?). I just know the general concensus from doctors in Slovenia is that diabetics SHOULD NOT treat themselves as disabled and they don’t treat us as such, either. I think it’s mostly because of the psychological impact + the fact that someone who takes care of themselves shouldn’t really have that much of a problem with diabetes. The reality of course is a bit different, and some people (like people with frequwent hypos) do get on partial disability…
Also, it takes a lot of extra time to take care of our diseases and that should be acknowledged, yes.

In the US, disability status has quite a bit to do with legal protection from discrimination rather than benefits eligibility. Sometimes both, but diabetics being “disabled” is mostly about protection from unfair treatment by employers and housing authorities.

People with diabetes are afforded some privileges in the workplace to make sure they can work to same effect as others: extra time to eat if necessary; safe, clean spaces to test blood sugar and inject insulin; etc.

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For instance, there is this story going around right now about this diabetic supermarket cashier who was not allowed to keep a sugared beverage next to her stand. Illegal practice of course for the employer to do that - but if diabetes was not a “disability” it would not be.

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I’d side with the employer. I require zero special privelages to manage my diabetes. This cashier could just as easily keep glucose tablets in her pocket like I do instead of demanding an unnecessary accommodation. People who try to play the disability card unnecessarily with diabetes get no respect from me.

My 12-yr-old son requires lots of privileges from school to be able to function normally:

  • leave the room any time he needs to inject
  • eat in class at any time
  • longer time to take tests if he gets hypo
  • bring his lunch out of the cafeteria and into class if he is high at lunch time
  • miss school in the morning when he spends half the night fighting highs or lows, 10 times more than glucose-normal kids
  • work from home when he is sick because a virus that is over in a day for other kids takes him a week to recover from

I could keep on going. Why would any employer be an a-hole and not let a diabetic employee keep a darn bottle of pop next to her seat? I have hired and employed hundreds of people in my life - and fired a good number because they did not perform where I needed them to. But I have always tried to make resaonable accommodations for their lives - even if it had nothing to do with health conditions. I don’t think it is bad at all if the law tells the employer that he must make reasonable accommodations.

The problem, really, is for all the cases when people want to abuse the law - and I have had to face several such cases in the past from the employer’s side. In the end, there are a-holes on both sides of the law - but the employer has the more powerful position, so it makes sense that the law would tend to help the weaker side.


Because the soda bottle is not necessary. Those needs the employee has can be met by other reasonable means just as well without the disruption to the workplace policy, such as glucose tablets. Therefore I would consider that accommodation to be an unreasonable one, but hey that’s just me. Stopping briefly to test blood sugar for example, as needed, and treat as necessary is a reasonable accommodation… the soda is just an obnoxious undermining of the policy…