Diabetes and Your Work

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Diabetes and work don’t always mix. How do you manage food, medicines, rest, monitoring, exercise, and work, especially if you’ve got demands, deadlines, and a boss who’s sweating you? How do you deal with the stress?

I asked my son’s 22-year-old friend Don, who was diagnosed with Type 1 in 2008, about his data input job. “Don’t even ask,” he said. “On weekends, I can eat like I’m supposed to. I can test when I need to, exercise if I want to. That’s hard enough. But at work? I don’t think so. We get one lunch break of 35 minutes. We’re supposed to get coffee breaks, but nobody takes them. We’re too busy, so we stay at our desks and type.”

I asked Don if he knew about employment law requiring employers to make “reasonable accommodations” for illness and disability, including time to monitor and a private place to do it. “I’ve heard of stuff like that,” he said. “The boss tells me I can test if I really need to, but he says things like ‘don’t take advantage of my good nature.’ I’ve only had the job six months and don’t want to [antagonize] him.”

Don may be right to worry. According to the American Diabetes Association, anti-diabetes discrimination at work is a major problem. According to this ADA Web page, “For workers with diabetes, employment discrimination can take many forms, but typically includes a failure to hire or promote you because of your diabetes, termination due to your diabetes, or a failure to provide you with reasonable accommodations that help you do your job.”

But worse than discrimination may be a work environment’s direct effects on your health. Work can be a major source of stress, which we know increases insulin resistance and blood pressure. Work stress can lead to consuming unhealthy food, being too tired to exercise, or having difficulty sleeping.

All these problems are worse when a person works rotating shifts. According to Mayo Clinic nurses Nancy Klobassa Davidson and Peggy Moreland, if you have diabetes you should “eat your meals around the same time each day, check your blood sugar at certain times, and get regular exercise and consistent sleep. But…you might work 4, 6, 8, 10, or 12 hours shifts, varying days a week. Throw in some overtime, and you may forget what day of the week it is, let alone remember whether or not you have taken your diabetes medication when you should have.”

What can you do to protect yourself from shift rotation? Moreland and Davidson say you may need to check sugars more often. “Always bring your blood sugar meter with you. Check your blood sugar a few times during the shift.” Different shifts may require different insulin doses and food intake. They suggest letting your supervisor know when you will need to take a break to monitor and possibly snack. Make sure you bring snacks with you. Insulin doses and times may need to change if the times you are eating and sleeping change.

Even without shift rotation, managing diabetes at work can require some creativity. The Americans with Disabilities Act requires employers to make accommodations if they’re “reasonable.” That is, if they don’t cost too much or disrupt work too much.

According to the Web site, “Reasonable accommodations can include:

  • A private area to test blood sugar levels or to take insulin
  • A place to rest until blood sugar levels become normal
  • Breaks to eat or drink, take medication, or test blood sugar levels
  • Leave for treatment, recuperation, or training on managing diabetes
  • Modified work schedule or shift change”

It can be scary and actually risky to ask for accommodations. You might wonder: are you making yourself a target, or being unreasonable? Small companies may not feel they have the resources or knowledge to make accommodations. The Americans with Disabilities Act only applies to companies with 15 or more employees. says you should just come out and ask. They give this example: “A custodian tells his supervisor that he recently has been diagnosed with diabetes and needs three days off to attend a class on how to manage the condition. This is a request for reasonable accommodation.”

But will the employer see it that way? Or will he start looking around for reasons to let that custodian go? A good American Diabetes Association paper on protecting your rights as a worker can be downloaded here and one on your rights in finding a job read here.

It all sounds difficult to me. I’m so glad I can work from home, and I think I’ll keep doing it that way. But how does this work for you? Can you manage diabetes and work, too? What accommodations have you asked for and/or received? What are the best tips you have learned for successfully working with diabetes?

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