Why Employers Should Care About Diabetes in the Workplace

By Bridget Miller
In yesterday’s Advisor, guest columnist Bridget Miller highlighted October as National Disability Employment Awareness Month and what it means for employers. Today, Miller describes an increasingly prevalent disability—diabetes—and what employers should be aware of, including training implications.

The Centers for Disease Control and Prevention (CDC) estimates that approximately 9.3% of the U.S. population has diabetes (as of 2014). This equates to nearly 30 million people and clearly is something that will affect most employers. An individual with diabetes is at higher risk for blindness, kidney failure, heart disease, stroke, and more.
Given the prevalence of diabetes, it’s nearly inevitable that employers will, either knowingly or unknowingly, employ someone who has diabetes at some point. Employers must be aware of what this means in the workplace. Here are some considerations:

• Employees with diabetes will be covered by the Americans with Disabilities Act and may need accommodations to manage this chronic condition. For example, employees with diabetes may need to be accommodated in terms of taking breaks to eat before their blood sugar gets too low or taking breaks to administer medication during the workday. They may also have more regular medical appointments than other employees or may suffer from complications.
• Employees with diabetes will also qualify for Family and Medical Leave Act leave (if otherwise qualified). This may come into play with diabetes management, such as when dealing with bouts of high or low blood sugar, or for continued treatment; or for handling complications from the disease.
• Type 2 diabetes can sometimes be positively influenced via lifestyle changes. This is relevant for employee wellness initiatives through an employer-sponsored wellness program. Employer wellness programs could also offer blood glucose screening.
• Employers may be well-served to offer employee training that includes information on what to do if you suspect another employee is having a hypoglycemic (low blood sugar) emergency.
• Employers may be concerned for employee safety if an employee with diabetes is in a safety-sensitive role. (There is no cause for concern in a non-safety-sensitive role.) The primary concern would be if there is any risk of the employee becoming severely disoriented or incapacitated while working—which would only be the case if a medical professional notes there is a risk of severe low blood sugar (hypoglycemia). However, the employer needs to also understand that there should not be cause for concern unless there has been an ongoing demonstrated problem. Diabetes can be managed to avoid safety issues in most cases. Even if an employee experiences an isolated case of low blood sugar while at work, this alone should not be cause for concern. In the absence of a demonstrated ongoing problem, an employer should not discriminate against an individual simply because they have diabetes. Even with multiple instances, if a root cause is found and corrected (such as a change in insulin dosage), it still should not be cause for concern. Undue concern—to the extent of taking away responsibilities—can appear discriminatory and is often not warranted.
• Employers may want to consider providing a safe place for employees who inject insulin to dispose of their injection needles.
• Employers may want to consider how well diabetes is covered under their health insurance plans, as this could directly affect an employee’s ability to stay on the plan and even to stay employed with the organization. (If costs of diabetic supplies are covered better under a specific plan, and that plan is cancelled or changed, that could mean significant costs for the employee.) Costs of managing diabetes can affect quality of life for an employee.
• An employee with diabetes may be seeing an endocrinologist to help manage the condition—and may have a significant history with that medical professional. If health insurance changes, this could mean that individual has to change what endocrinologist they see, which represents a huge change and may be something that will cause an employee to seek other employment to regain insurance coverage with their preferred provider.
• If an individual experiences one or more complications from diabetes, additional accommodations may be necessary.