Fighting Fires And Type 1 Diabetes

An interview with Janine Langenhoven, a firefighter with Type1 diabetes.

Janine: I have been  a Type 1 Diabetic since I was 20 years old. I was diagnosed on the 21st of January 2002, three days before my 21st birthday, (laughter) - this is a family joke as I always tell people it was my 21st birthday present. But let’s start at the beginning. I started having flu like sign and symptoms and loosing weight very quickly - 14kg in a month! The flu symptoms didn’t seem to go away. My GP at that stage was Dr Potgieter, who recommended a routine check-up. He also tested my blood sugar, only to realise it was 25.6mmol/L.  He wanted to know if we have Diabetes in the family.  I had a glucose tolerance test the following morning and after the long sit and drawing of blood the results confirmed that I had diabetes. 

I went home with so many questions that were unanswered and so many concerns going through my mind. It felt as if my whole world was crashing down around me.

My Dad has Type 1 diabetes as well. He was diagnosed when he was only 16 years old. He is now 60 years old. He is a remarkable man who has completed 14 Comrades marathons, 9 Duzi’s (canoe races) and he has done a few Cape Argus races as well! 

Diabetes has been part of my life ever since I was born. Dad used to check us regularly. He also explained the symptoms and health implications of the condition. He showed us how to live an unlimited life.

I started on multiple daily injections. My blood sugar became more stable but I started having a lot of low sugars. I struggled with low blood sugars for a few years. My Dad asked his endocrinologist to refer me to a specialist.  He recommended Dr G.Podgorski - a significant improvement followed.

I had one hypoglycaemic coma in October 2008 which I hope and pray never happens again. In March 2012 my doctor recommended insulin pump therapy. My HbA1c was 7% but I was still suffering from nighttime hypos.  Insulin pump therapy helped me to get better control of my diabetes. It’s been almost 16 years since diagnosis and I am still going strong! I would have never made it this far without the awesome support system My Dad, Hugo, my Mom and friends. I believe one’s support system is a very important factor in managing diabetes. 

I am now under Dr Gregory Hough’s care since August 2016.   My blood glucose control is way more in the normal range and my HbA1c is 5.9% which I struggled to sustain initially.  I started with a low carb diet and I do Cross-Fit 3 – 4 times a week and sometimes even more if I can ☺. 

When did you become a firefighter?

Janine: I was still in school when I applied to the Fire Department.  I didn’t have T1D then so I had no idea that I was going to have to juggle my career and my health. This was a steep learning curve.  I surfed the internet endlessly to find one person who was living with T1D and has a demanding job like mine.  At that stage I just could not find anyone.  Managing my diabetes at work became a trial and error. With the help of my Dad and family I got through this difficult time and I am still going strong.

What are the biggest challenges in your work and how do you overcome them?

Janine: This is a difficult question to answer as it’s mostly the different scenarios and challenges and they can catch you unaware.  You can prepare yourself as best you want but it depends on what awaits you on that specific incident. There is the constant challenge of whether my blood sugar will rise or fall and the aftermath of a large fire with the challenges of extreme heat that might cause dehydration. I believe that we as humans adapt to our surroundings and I can cope well in a fire scenario. To be honest I think it’s so part of me that I just do it and deal with the hypos afterwards. I just make sure that I have juices, glucose sweets etc in my bunker gear at all times and a small glucose meter.

The most recent fires in PE must have been very tough on you. How did you manage fighting fires for such long hours?

Janine: That is genuinely a good question! It is so part of my life that I just know how to manage it. I do meal preparations and I always have snacks with me including apple juice boxes, small nut butter sachets and the purity squeezes which doesn’t make my blood sugars spike to high but helps me to keep healthy and stay alert. The most important thing I do is test a lot - over 10 times a day especially when I’m at work. I have a small cooler bag that I take with me to work.  I also have a protein shake for those times when we are out for long hours. I make sure that I drink at least 3 litres of water daily.

How does insulin pump therapy help you as a firefighter?

Janine: Insulin pump therapy helped with better control.  Better control and a low A1c make me feel much healthier. A lot of people with T1D see the pump as a hassle -  I initially believed this as well, but when I started seeing the results and saw how my control improved I changed and eventually have grown to love and adore my little artificial pancreas. My pump is an integrated system.  That means, it not only gives me insulin but also monitors my glucose levels every 5 minutes. With the continuous blood glucose monitoring, my Paradigm Veo pump suspends for 2 hours when my blood sugar drops. Sensors help a lot to get better control but most medical aids don’t pay for sensors.  My current medical aid is not paying and I have to buy them out of my pocket which I can’t afford every month. This is causing me to do loads more testing. 

What will your message be to young Type 1 children?

Janine: Don’t let T1D define you, you are stronger than you know and you can do anything you set your heart on. Never stop reading and exploring ways to get better at controlling diabetes and test, test, test.  Follow a healthy diet with protein (meat) veggies and little fruit.  Exercise is very important!  Lastly, if anyone tries and tell you, you can’t - prove them wrong!

We heard you will be competing in a Cross-Fit challenge?

Yes! I am also participating in the Eastern Cape Cross-Fit Championships in September - I look forward sharing this experience with you soon!

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