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Managing Diabetes in the Workplace 

A. Employers Play a Key Role

Employers are concerned about the impact of diabetes on their bottom line but may not fully understand the complexities of diabetes and the implications for employees. They can play a pivotal role in helping their plan members and families reduce the risk of developing type 2 diabetes, and delay or reduce the risk of type 1 and 2 diabetes complications. Employers and insurers are a key link to helping members navigate their health, says Adams. “Having a strong diabetes program for employees within benefit plans enables education and access to care. Helping employees and their families better manage or reduce the risk of type 2 diabetes has a positive impact on employers’ bottom lines while improving member health.” Clarke concurs: “I love the saying ‘If you don’t spend on wellness, you’ll have to spend on illness.’” “Despite the fact that diabetes is a serious epidemic in Canada and throughout the world, there continues to be a significant gap in the knowledge and awareness of risk factors accompanying this condition,” says Clarke.

“When we identify that diabetes is a significant cost to an employer,” she says, “we’ll review their benefit plan through a lens of diabetes management to ensure access and coverage to necessary medications, supplies and support services to help employees effectively manage their diabetes and function successfully in the workplace.”

The work environment can influence and impact an employee’s ability to manage their condition. “My health is super important to me,” says Pelcz, “and I think that it should also be important to employers, because better diabetes management leads to improved performance at work.” She feels that employers with knowledge of diabetes, and who show support toward employees living with diabetes, can lead to improved health and performance. “I recommend that employers gain basic knowledge of diabetes and how it can affect an employee’s ability to perform at work. This will assist employees in their well-being and mental health.”

Sometimes employers don’t always know if people have diabetes, but if they do, Pelcz recommends that they talk to them and express their interest and support in order to help them reach their full potential in their role.

If you don’t spend on wellness,
you’ll have to spend on illness.

Lack of support for employees with diabetes can lead to absenteeism and loss of productivity over the long term. Research shows that workplaces that could not adequately provide support for their employees’ self management increased the risk of diabetes-related long-term complications, in part because employees would let their blood glucose rise to higher-than-optimum levels to avoid hypoglycemic events.125 Workplaces need to recognize the importance of diabetes and provide a supportive environment for employees who have diabetes or parents with a child who has diabetes (see Suggested Workplace Accommodations for Employees with Diabetes).

 

B. Diabetes and Workplace Safety126, 127

Hypoglycemia and hypoglycemic unawareness can be significant, and unwanted treatment side effects present risk of cognitive impairment and potential safety implications. Some safety-sensitive positions require a determination of medical fitness because impaired performance could lead to an incident that could affect the health and safety of employees, the public, property or the environment.

For most other workers, a supportive workplace that includes accommodations for employees with diabetes can mitigate many of the risks.

 

C. Workplace Program Ideas 

Consider programming that encourages employees or their family members living with or at risk of developing diabetes to work with their healthcare providers to reduce their risk of diabetes and potential complications.

 

i. Best Practices for Workplace Diabetes Programs

Medavie’s Adams’ recommendations for workplace diabetes programs:

  • Champion a holistic approach to diabetes – take care of the whole person, rather than just blood sugar
  • Ensure benefit coverage for medications, services and tools within the health plan (e.g., supplies, devices, health coaching, mental-health support)
  • Embrace solutions that leverage digital health and virtual care, as well as innovation and modernization of treatment
  • Design programs that are convenient to access and easy to understand
  • Run targeted campaigns to encourage engagement in the program and reduce barriers to accessing care

 

ii. Employee Diabetes Screening Programs

“Ideally, if we can get past COVID, a diabetes screening program should be offered onsite to employees along with the chance to consult with a diabetes educator,” suggests Clarke. Many people live with prediabetes or diabetes but haven’t seen a doctor or been formally diagnosed or treated. “Years of unmanaged diabetes increases an employee’s risk of heart disease, nerve damage and kidney disease. Workplace screening programs offer employees a chance to understand their risks in the convenience of their workplace.” Employers can also offer the Canadian Diabetes Risk Questionnaire (CANRISK), which can help employees find out if they are at higher risk of having prediabetes or type 2 diabetes (available at: https://canadiantaskforce.ca/wp-content/ uploads/2016/05/2012-type-2-diabetes-canrisk-en.pdf).

 

iii. Workplace Educational Programs

Workplace diabetes education programs should focus on information, tools and activities that make the connection between healthy behaviours and the reduction of chronic conditions like diabetes.

Suggested Workplace Accommodations for Employees with Diabetes:128, 129, 130, 131
  1. Private place to administer medications or conduct glucose checks
  2. Storage for food, medication and testing supplies near workstation or break area
  3. Flexibility to take breaks or leave meetings to treat or prevent low glucose (e.g., to eat or drink, take medication or check glucose levels)
  4. Permission to carry and consume emergency sugar
  5. Time off to attend medical appointments
  6. Place to rest until glucose levels stabilize
  7. “Sharps” disposal for insulin needles
  8. Physical activity encouraged
  9. Healthy food options provided
  10. Structured self-help programs and education in diabetes care
  11. Smoking cessation programs
  12. Permission to wear a smartwatch or have access to a smartphone when these
    devices are the display devices for viewing glucose data, alarms and predictive
    alerts
  13. Organizational factors and mental-health factors to reduce stress

Sometimes employees with diabetes might need an unscheduled break, says Pelcz, “because we might have a low blood sugar in the middle of a shift and it is important for us to treat a low blood glucose level, so we return to optimal performance.”

Diabetes Canada has a wide variety of resources and programs for employers who want to offer workplace support and education.

  1. The Canadian Diabetes Prevention Program, a free, 12-month digital coaching program that empowers Canadians to lead a healthier life and reduce their risk of developing type 2 diabetes.
    https://www.diabetes.ca/diabetes-prevention-program
  2. Ask the Experts Video Series, which provides answers from experts – doctors, clinicians, scientists and key stakeholders – on current priorities for individuals living with and impacted by diabetes.
    https://www.diabetes.ca/resources/tools---resources/ask-the-experts
  3. Webinars on numerous diabetes-related topics.
    https://www.diabetes.ca/resources/webinars?Categories=&SearchText=&Sort=&Page=1
  4. Diabetes Canada YouTube Channel, which has many resources, including webinars, Ask the Experts, healthy eating and physical activity videos.
    https://www.youtube.com/user/CDA1927

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125 https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-386

126 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3431894/

127 https://www.diabetes.ca/learn-about-diabetes/your-rights/employment-discrimination

128 https://www.ccohs.ca/oshanswers/diseases/diabetes.htm

129 http://website60s.com/upload/files/12-diabetes-in-the-workplacethe-hazards-of-hypoglycemia.pdf

130 https://www.diabetes.ca/learn-about-diabetes/your-rights/employment-discrimination

131 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3431894/