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Diabetes in the workplace
There are over 425 million people worldwide living with diabetes and this is estimated to rise to 592 million by 2035. In 2013 there were 3.2 million people with diabetes in the UK with this estimated to rise to 5 million by 2025. This currently equates to 1 in 17 people living with diabetes in the UK. 90% of these are type 2 diabetes which is considered a preventable disease with the correct diet and regular exercise.
1 in 2 people with diabetes is estimated to be undiagnosed and early diagnosis and treatment is key to preventing the long-term complications of diabetes. It is therefore important that people be made aware of the risks, symptoms and management of diabetes and that those at risk are regularly screened.
So, what is Diabetes?
When we eat, food is broken down into glucose also known as sugar, which then enters our bloodstream. Our blood sugar is controlled by a hormone called insulin which is produced by the pancreas. The sugar in our blood is moved into our cells by the insulin and is then used for energy. In diabetes there is either not enough insulin or the insulin isn’t working well enough.
Type 1 diabetes occurs mainly in children and young people and equates to 10% of those living with diabetes. While Type 2 diabetes, is more common and occurs mainly in adults, equating to 90% of those living with diabetes.
Type 1 Diabetes
Type 1 Diabetes develops when the body’s immune system attacks and destroys the insulin producing cells in the pancreas, the cause of this is unknown.
Type 2 Diabetes
Type 2 Diabetes develops when the body doesn’t make enough insulin or the insulin the body is making is not being used properly.
Complications of Diabetes
Poorly controlled diabetes can lead to:
- Heart disease and stroke
- Kidney disease
- Eye disease
- Foot ulcers and Nerve damage
- Amputation due to poor circulation
- Sexual dysfunction
- Complications during pregnancy
- Gum disease
- Increased incidence of bacterial infections
People living with type 2 diabetes have a higher risk of developing cardiovascular disease which is a major cause of death and disability.
Symptoms of Diabetes
Please visit you GP as soon as possible if you are experiencing the following symptoms:
- Being very thirsty
- Urinating more frequently, especially at night
- Genital itching or frequent thrush
- Feeling more tired than usual
- Unexplained weight loss and muscle loss
- Poor wound healing
- Blurred vision
Research has shown that family support is essential in improving the quality of life of those living with diabetes. This can only be effective through ongoing promotion and education on diabetes. This will be addressed in a future blog.
Diabetes in the Workplace
Diabetes does not necessarily affect a person’s ability in the workplace, but they may at some stage need some adjustments.
Is Diabetes a Disability
The Equality act 2010 defines disability as a physical or mental impairment that has had a substantial and long-term negative effect on a person’s ability to do normal daily activities, whereby long-term means 12 months or more. Because diabetes is a lifelong condition, if a person requires support to manage their diabetes and it is seriously affecting their ability to carry out normal daily activities, they may be considered disabled under the act. Additionally, the act states that if a condition is treated or corrected, the effect of that treatment or correction should be ignored when assessing the condition and the impact on the employee. A diabetic taking insulin injections may show no signs of impairment, however if the individual were to stop taking the insulin their diabetes will have a substantial impact on their ability to carry out day to day activities.
Please see https://www.equalityhumanrights.com/en, http://www.nhsemployers.org/~/media/Employers/Publications/Diabetes.pdf and https://www.diabetes.org.uk/resources-s3/migration/pdf/Employment-advocacy-pack-2013.pdf for more information.
Adjustments in the Workplace
- Because testing is essential to the management of diabetes, control and prevention of complications, provision may need to be made allowing time for this during the day. In addition, they may need a private and hygienic area in which to do this. The following Links may be helpful
- Awareness in the Workplace can ensure that all colleagues are aware of the symptoms of hypoglycaemia and know how to help the employee in this situation.
- Diabetes control is affected by stress and illness and in turn can worsen the illness. During periods of illness, the diabetic may need to adjust their medication, test more frequently and manage what they eat and drink more closely. They also tend to recover from illness longer than those without diabetes. Employers may need to adjust their policies to allow adjustments to sickness absence level, reduced disciplinary triggers and productivity levels.
- Diabetes can affect vision temporarily during hypoglycaemia or permanently due to poor control. Regular eye tests should be conducted to ensure the employee is fit to perform their duties. Employees may need a risk assessment when in safety critical environments as they are at risk of episodes of hypoglycaemia which can cause sudden incapacity and high blood sugar can cause blurred vision. Having diabetes doesn’t mean they have to give up driving but those on insulin are required to notify the DVLA.
- In pregnancy women will be required to attend extra monitoring appointments and scans to ensure both mum and baby are doing well and that the baby is growing and developing normally. Women may also need regular adjustments to their medication and may therefore need time off work to attend appointments.
- There should be no restriction in the type of job a person with diabetes can do, however some safety critical jobs may have requirements that are difficult to meet. Diabetics must be assessed individually for these roles and not blanketly excluded.
- As with all chronic illness, diabetes may affect the emotional wellbeing of an individual. Diabetes can be challenging and time-consuming to control and It is well known that diabetics are more prone to depression. In addition, stress affects blood sugar control. It is not uncommon for people diagnosed with diabetes to feel overwhelmed and frustrated by their disease. Employers need to be aware of this and provide support when needed in accessing help either through their GP or a Counsellor.
The role of Occupational Health
With the incidence of diabetes in the workplace rapidly increasing, so too is the impact on health in the workplace. By simply paying more attention to the physical health and needs of staff and making them aware of the importance of lifestyle changes can make a big difference in the workplace by reducing sick absences.
Regular screening can assist in timely diagnosis of diabetes, thereby improving the complications of diabetes which will reduce sickness absence and improve productivity.
In some job rolls, employees may need a risk assessment when in safety critical environments as they are at risk of episodes of hypoglycaemia which can cause sudden incapacity and high blood sugar can cause blurred vision.