The first issue surrounding diabetes and working offshore is that you must disclose to your employer and occupational healthcare provider that you have the condition.
You cannot take the risk of not admitting that you have diabetes – your health and safety must be your priority. So how do you live with it?
There are two main forms of diabetes – type 1 and type 2. Insulin is a hormone released by the pancreas to help control the levels of sugar in the blood. Diabetes type 1 occurs when the body fails to produce insulin. Type 1 diabetes usually appears before the age of 40 and is a lifelong condition that cannot be cured, but can be controlled.
Diabetes type 2 is the most common form of diabetes and accounts for about 90% of all diabetes. It is caused when the body doesn’t produce sufficient insulin or is not using the insulin produced efficiently. It is often possible to lead a healthy and active life if diabetes type 2 is well managed. For many people, it can be managed by diet alone, but for others, it is necessary to take medication in pill form.
Occasionally, after a length of time has passed, it may no longer be possible to control the condition by diet and/or medication, and in this instance, it will be necessary to begin using insulin injections. Diabetes type 2 is often associated with being overweight and lack of physical activity.
In the past, if you had type 1, offshore work would be summarily ruled out for you. If you were insulin-dependent, the decision was cut and dried and offshore work was simply not an option.
However, times and regulations have changed and now diabetes type 1 does not automatically preclude you from being issued with a OGUK Offshore Certificate.
Each case is looked at individually. It is likely you will require reports from your GP and specialist to confirm that your condition is under control. Your operator will discuss your specific case with its medical adviser, who will provide it with an expert opinion as to whether it would be an acceptable risk for you to work offshore.
The risks associated with insulin-dependent diabetes are incompatible with unrestricted fitness to work, so if you are issued with an OGUK Offshore Certificate, it will be restricted to a maximum of one year. A restricted certificate would be valid for a named installation and the medic on that installation must be competent in the management of diabetic emergencies.
If you want to work offshore, you can see why it is so important to strive to control your blood-glucose level to remain as healthy as possible. Your GP or specialist clinic can give you advice on monitoring and managing your blood-glucose levels, and their guidance needs to be followed meticulously. Maintaining a healthy lifestyle will be of enormous help to you, and you must eat regularly as part of a healthy diet.
If you have type 2 that can be controlled by diet alone or diet and tablets, then it will not be an obstacle to working offshore provided the condition is well controlled and there are no complications.
It may be appropriate for the frequency of medicals to be increased to make sure that your overall condition is regularly reviewed. Again, it is in your interest to maintain a healthy lifestyle, and diet should be low in fat, sugar and salt.
You can help to prevent complications of diabetes by not smoking, not exceeding recommended alcohol limits and ensuring that your healthy diet keeps you at an ideal weight. Taking regular exercise will be of benefit and is an excellent aid to managing the condition.
It is useful to know that regular exercise will help to maintain your ideal weight and lower blood sugar, plus aid your cells to accept insulin more effectively. You can ask about what types of exercise would be beneficial for you at your specialist clinic, or speak to your GP.
So it’s not all bad news for offshore workers who have diabetes.
Type 1 means your case requires individual assessment before the possibility of a restricted offshore certificate can be issued.
Well managed type 2 will not prevent you from working offshore. Either way, your continued health lies, to an extent, in your own hands. Although diagnosis of diabetes can be a blow, learning to control the condition can be an empowering experience.
Living a healthy lifestyle is a bonus for all of us and benefits not just those with diabetes who live rewarding lives and fulfil their career ambitions.
Dr Louise Smith is a medical officer at occupational-health specialist Abermed
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