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Diabetes on the Job
There are few things that you can’t do as long as you are willing to apply yourself. —Greg LeMond
Diabetes affects almost 26 million people in the United States, and it stands to reason that many of those people work. Being gainfully employed can be rewarding and, very often, with benefits such as health insurance, a necessity. However, the workplace can add to the challenges of managing diabetes, in a number of ways. Take the time to think about what your diabetes care needs are and how they affect or fit into your workday, and make sure to plan for you and your diabetes on the job.
If you work outside or in another environment that may be hotter or colder than the ideal temperature for your diabetes supplies, get an insulated bag and use a heating or cooling pack as needed.
For the protection of all the employees in your workplace, make sure you have a sharps container available to safely dispose of any lancets or needles you use during the workday. Some workplaces provide sharps containers, but if yours doesn’t, you will need to bring your own.
If you are at risk for hypoglycemia (low blood glucose), always keep items available for treatment. The best options to carry with you and/or keep at work are those that are portable, nonperishable, and do not need refrigeration, such as glucose tablets.
Breakfast. If mornings are a particular problem, get things ready the night before. Set up the coffee pot and get out any dishes or utensils you’ll need. Have a back-up breakfast plan if you are unable to take a few minutes to sit down and eat. Keep healthy, on-the-go options on hand, such as dry cereal and fruit that can accompany you on your commute. Always measure out the amount you need so you can stick with your recommended carbohydrate intake for that particular meal. It is not wise to skip breakfast for a number of reasons. One is the possibility of developing hypoglycemia if you are at risk for it. This could actually delay you getting to work since you’d need to stop and treat it.
Office cafeteria. If your workplace has a cafeteria, it may be to your advantage to get to know the cooks. Let them know you are interested in healthy eating, and ask them to share information with you — such as the Nutrition Facts panels from labels of foods served in the cafeteria — so you can make appropriate choices for your meal plan. The cooks may be willing to modify certain recipes or use lower-fat cooking techniques if you ask. Simple adjustments like putting sauces on the side and grilling instead of frying go a long way toward healthier eating. Remember to show your appreciation and let the staff know they have made a difference by helping you stay on track with your meal plan.
Off-site food options. If you don’t have a cafeteria or similar place to buy meals at your workplace, you may head out to a restaurant, deli, or grocery store at mealtimes. On a regular basis, this option can get expensive and offer many challenges for healthful eating. However, you may be able to identify nearby restaurants with healthful choices or a good grocery store salad bar. Keep your meal plan in mind as you order, and aim for simple, low-fat dishes over heavily sauced meats and vegetables.
Brown-bag meals. The best option for eating healthfully at work may be to bring food from home. This allows you to control what you eat, how the food is prepared, and how large your portion sizes are. It may save you money, as well. To keep your food cool, use the workplace refrigerator, or purchase an insulated lunch bag and reusable freezer packs. If you have a microwave at work, you can also prepare hot meals in minutes.
Healthy snacks. Whether or not you make snacks a regular part of your meal plan, it is a good idea to keep some healthy snacks at work to tide you over when the need arises. If you have access to a refrigerator, you might choose to bring in items such as fruit, yogurt, or carrot sticks. Nonperishable items such as granola bars, nuts, and rice cakes can be stored in your desk or locker.
Having snacks handy will help you to avoid hitting the vending machine or eating “treats” brought in by coworkers when you’re hungry or are in a hurry. It is a good idea to prepackage your snacks into the portions you desire so you can avoid overeating, especially while preoccupied with work.
People who primarily sit at work will want to figure out when during the day they can get up and move around. Using breaks to walk up and down the stairs or walking a few laps around the building during lunch may help offset higher blood glucose levels from lack of movement while you work. Try to squeeze in at least three 10-minute sessions of moderate activity a day for a total of 30 minutes daily. When you meet with your diabetes care team, discuss the nature of your job, your activity level at work, and how best to meet your physical activity goals during or outside of work.
If you have flexibility in your schedule, try to plan meetings or intensive projects for times other than when you need to eat or perform other parts of your diabetes treatment plan. If you don’t have much flexibility, you may want to discuss your break times with your manager so they can be scheduled for times that work well with your diabetes regimen.
If you work long hours (more than 7 or 8 hours a day), you may need to plan for two meals at work, rather than just one, as well as more blood glucose monitoring, taking medicines, and finding a way to work some activity into your day.
Working an evening, night, or rotating shift can be particularly challenging when it comes to diabetes control. This is in part because shift workers tend to get fewer hours of sleep overall than do people who work regular daytime hours. In addition, figuring out the best times to sleep, eat, and exercise can be difficult. In general, you will still need to match your diabetes medicines to your meals, no matter when those meals occur.
It’s a good idea to speak to your diabetes care providers about managing your diabetes if you do shift work. It can also help to keep detailed written records of when you’re sleeping, eating, exercising, and taking medicines and what your blood glucose levels are at these times. This can guide you and your care providers in making adjustments to your regimen.
Safety at work
The Occupational Safety and Health Act of 1970 (OSH Act) requires employers to provide their employees with working conditions that are free of known dangers. In addition, employers have a legal obligation to inform employees of OSHA safety and health standards that apply to their workplace. Be sure you are aware of the safety policies and procedures of your workplace, and inform your employer about any unsafe conditions that you observe.
If you have any diabetes complications, you may have some special needs regarding workplace safety. For example, if you have certain types of retinopathy (an eye condition), a job that includes heavy lifting may not be advisable. If you have neuropathy that causes lack of sensation in your feet, wearing steel-toed shoes or boots may put too much pressure on your feet and cause an injury. Speak with your diabetes care providers (including any specialists you see) about your work environment and the work you do to assure that your job duties are not endangering your health or your diabetes control.
Educating your employer
The Americans with Disabilities Act requires employers to make reasonable accommodations for employees with diabetes to permit them to perform essential job functions. The specific accommodations to be made depend on the needs of the individual. Some examples of accommodations an employee with diabetes might need include the following:
• A private area to check blood glucose or take injected medicines
Employers must always handle any information about an employee’s medical condition or disability in a confidential manner. You can learn more about your rights as an employee at the Web site of the Equal Employment Opportunity Commission, www.eeoc.gov.
If you truly feel discriminated against in the job setting, the American Diabetes Association may be able to help. See “Resources for Workers” for contact information.
Any of these situations can be stressful, and such added stress can affect your blood glucose control. There’s no easy fix for job stress, but being aware of your emotional responses and doing your best to care for yourself emotionally and physically can help. Advocating for yourself in the workplace — by letting your supervisor know when a deadline is unrealistic, for example — and making constructive suggestions about what could be altered in the work environment may lead to positive changes.
If you are feeling down and out and can’t seem to shake feelings of sadness or irritability, are unable to concentrate, or have low energy, you might be depressed and need professional help. You should seek help from your diabetes care provider or possibly from an employee assistance program, if your workplace has one.
Employee wellness programs
If your company does not currently have such a program and you’d like to encourage one, your employer can find a wealth of information on employee wellness programs that are specific to diabetes at www.diabetesatwork.org. Remind your employer that a healthy lifestyle is important for everyone, not just for people with diabetes. Studies have shown that high-quality employee wellness programs improve staff health and well-being, which may, in turn, reduce absenteeism, health-care costs, and disability claims.
In addition to wellness programs, some worksites also have medical personnel on site, such as nurses, occupational medicine physicians, or other health-care providers. Take advantage of these resources, and be sure to tell your diabetes care provider about any tests, immunizations (such as the flu shot), etc., that you have received at work.
Knowledge and resources
Stay in touch with your diabetes care team to make sure you are on the right track with your health. Periodically ask your diabetes care team for updates regarding your blood glucose monitoring equipment and diabetes medicines. Advances in monitoring equipment, medicines, and the delivery devices for medicines used to treat diabetes may simplify your management, making it easier to incorporate these necessary health items into your daily work routine.
Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.