Diabetes Self-Management Blog

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 dLife.com, “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.

dLife.com 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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Comments
  1. I am a Federal Employee so I have reasonable accomodations in the form of Family Medical Leave which includes diabetes of myself and any family members’ health problems I need to be absent for. I am a secretary and I can go to the room set aside for us and also for others with illnesses to go and test my glucose or take insulin shots if i need to. This is a small room with a locking door so there is also privacy. As long as my endo writes me a prescription or a note that I need to attend classes or whatever they are fine with it. I park at the extreme end of the huge parking lot and walk to and from my office daily. I have access to a cafeteria with salads, yogurt, sugar free jello, etc from 11am to 2pm and then the snack shop is open until 6pm. There is a nurse on duty downstairs always to check bp and glucose and anything else I need to have checked. Our building is so big that I mapped out with my pedometer how many times I need to circle our floor to make a mile. That way I can walk indoors safely. I do this before I leave to come home because I work until 8:30pm most nights. There are those days, though, when I am required to change my shift for different events and those are challenging. I think my employer does more than most and I understand that I am very lucky. I do not abuse this priviledge.

    Posted by Cathy |
  2. I was hired as the main secretary in a busy elementary school. It was hard, hectic and extremely stressful, so I got low blood sugars fairly often. My principal told me personally that she was ’squicked’ by my disease, but on paper said I was not doing a good job, so I lost that job. In retrospect it was a good thing, but I lost a big salary bump. I tried to pursue it at the district level, but was told that it was up to the individual school to decide what accomodations they could allow.

    Posted by Patricia |
  3. I guess I’m lucky as far as my work place goes with anyone who has medical problems. It’s the culture of the business that allows us to take care of themselves, or maybe putting it in a different light it is the culture of the people running the organization that allows it’s employees the time to take care of themselves. Currently I’m out for medical reasons, though I’m working part time from home, the benefit or curse of working in IT. I have type II diabetes, and I keep a monitor at work as well as at home and a pouch for meds I keep locked up just in case I have to work overtime, just so I can keep my med schedule on track.
    A short story about an organizations culture when dealing with medical challenges of it’s employees. I got a call from my supervisor a couple of weeks ago, she asked if I had a blood glucose tester with me, she stated she was having the shakes and wondered if her blood sugars high or low. I told her I would be down and we could test her blood, it seems low to the diabetes guidelines. I just looked at her and told her to call her doctor and make an appointment for her doctor to check. I told her I would wait in her office until she made the appointment. She made the appointment for the next day.
    Without employees who take care of themselves on the day to day basis it is hard to run a successful business. It’s cultural that must be taught.

    Posted by Robin |
  4. My supervisor, and especially my coworkers are very concerned about me and my diaabetes type 2. if they think I am not eating, resting or exercising, they let me know that’s not good. When they eat, they make sure I do likewise and eat on time. If I take off and go to the doctor, they allow for someone to answer my phone. They can look at me and tell when I need to rest or when I am stressed. My job is stressful and seeing customers on a day to day basis, only adds more stress, especially when I am not able to provide the services that they need.

    Posted by elowise/April 2l, 20ll at 3:45 pm

    Posted by elowise |
  5. This article showed up just on time for me. I work for the government and while we have great health care benefits, sick time and health programs (though the latter is only really distributed at our headquarters in the state capital 2 he’s away from most field offices) on the local level some management just doesn’t get it.

    I meet with people all day long and now due to budget cuts causing the closing of many offices we now travel quite a bit to meet people as close to wear they live as possible. Of the places we can be headquartered I was sent the farthest. It’s 32 miles one way and this is on top of any travel I might have to do once I get there. I’m exhausted from the driving back and forth and have had a few symptoms of lows while driving that have almost ended in a crash. There is another headquarters office closer to where I live and in the middle of the area I cover but when I asked to be transferred to it I was denied. In my request for the transfer I didn’t explain the medical side of it because first off by me being fairly young and lean most people don’t know or believe that I have Type I (I use a pump that no one really sees) so when I’m not feeling well they don’t always realize how serious it is. Yes it is documented in our HR dept but thats 2hrs from us so many in my lical area management dont know. I don’t usually tell them it’s because of diabetes when I’m sick because I don’t want it to be held against me in any way. I’m so confused and frustrated. All I know is I have to do something soon. I’m not eating well because I’m in a rural area w/nowhere to hear my lunch so I eat fast food most times, I’m not resting well and the stress of it all has my blood sugars going all willy nilly.

    Posted by Crystal |
  6. As a 63-yr-old woman with diabetes, sitting in a cubicle close to others all day, I am very susceptible to catching illnesses; I lead a healthy lifestyle and am never sick unless someone brings a germ to work. Last year a young mom brought Influenza A (diagnosed by a doctor) to work. She never missed a day but I caught it, was in bed for a week and almost lost my job. My employer - a health care company! - treats sick days harshly and put me on FMLA after only three days. Recently another co-worker brought in a virus, again diagnosed by a doctor, and made four older people ill, including me. She said she can’t afford to take a sick day. My manager has agreed to my request that I be moved or a few days whenever someone brings in a contagious illness, but she said she has no authority to send a sick person home. Do I or does any employee have the right to protection from exposure to contagious illnesses in the workplace?

    Posted by Jessie |
  7. In November 2010,I was let fired from a job that I had for having to many health issues.I was scheduled for 2 days a week,either Sat and Sun or Mon and Tues.My district manager would call me while I was at Dr’s.Appointments and ask me to come in to work,because someone called out sick.When I said no she would get upsetand talk about me to the other employees.I pulled a 10 hour shift one night and my legs and feet were so swollen I could barely walk,I went to the dr and was told to take 2 weeks off so I could get the swelling under control.I took the dr note to my nanger and he was cool with it but when I got released to return to work that was when the district Manager said I had to many health issues.Mind you I only missed 4 days of work in 2 weeks.I have not been able to find employment since that time due to my diabetes.

    Posted by Robert |
  8. Several years ago I worked in a position in which I often took clients out for lunch. My endo had stated, when I became insulin dependent for my Type II diabetes, that I should simply test and inject at the table once the food was placed in front of me. Obviously this meant testing and injecting occurred in plain sight of others at the table, although I did try to be discreet about both. After this had gone on for several years, my boss called me into her office and said that some people did not like seeing me do these things. She said I should just go to the restroom to test and take insulin. I explained that my doctor had instructed me to do things the way I was doing them. About two months later I was let go from the job. I have always thought my medical condition was an underlying aspect, but of course, she limited her criticism to job performance.

    Posted by Jeannie |
  9. When i got Type 2 Diabetes my employer after two weeks figured I would be Cured was seeing my Doctor once aweek to monitor my condition well my employer did’nt like that.5 months later in November 2003 I was ”Let Go” but by that time I was already Burnt out from all the BS,Politics that infest all workplaces.

    Posted by Cronos |
  10. I’m a correctional officer at a large jail. My discrimination was so bad that I have filed a formal complaint of discrimination with my state’s commission against discrimination and also with the Equal Opportunity Commission of the Unites States almost 3 years ago. My case is still ongoing. Before filing my complaint I had worked there for 5 1/2 years and only used 4 sick days, so I’m no slacker. The employer changed my previous medical accommodation resulting in making me stand and wait in line with the other diabetic prisoners waiting to take their insulin, before the nurses finally could get around to giving me one of the jail’s syringes. This invaded my privacy and exposed my medical condition to the prisoner population, placing me at risk.

    Posted by Chris |
  11. How does this all work with Firefighters who work 24 on 48 hours off?

    How do you impress upon your Chief, who is a marathon runner, that you who has not been the regular recipient of regular trainings during the course of the year, may get overheated and need to cool off at a heavy exertional training, when you asked that we stop at a drive thru on way to said training so as to have a relatively full stomach before doing the training and trying to rehydrate with water alone.
    Empty stomach, water, excess heat in a lesser insulated fire gear where you feel the heat of being inside of the iron/ steel aircraft simulator, putting out fires

    Posted by Brian Bowen |
  12. It really bothers me to see the amount of discrimination that employers get away with these days but more so age and disability discrimination. It is a shame what the ACLU has become and why. It is so bad that I dont think anyone will be able to right it at this point. Welcome to America!

    Posted by Michael |
  13. Four years ago when I was working at my last hospital job, I had to go to a private area to eat a snack because I was only allowed to take breaks at a certain time. As far as doctor’s appointments, I had to go on my off days;I couldn’t request a day off because I was told “That’s your problem.” Some supervisors or managers may not show moral support for the person with diabetes. Still, there are others who are concerned for your well being. Also, if you don’t have time to eat, you can keep a protein snack- such as peanut butter and crackers, cheese, meat jerky, protein bar or protein drink- with you to have it on hand.

    Posted by Kimerly |
  14. I have previously been a “victim” of where my employers would not allow me to test, eat, rest, etc. I am an RN, and because of my employers’ activities, I have had several severe lows. I use an insulin pump and also wear a continuous glucose sensor, but it’s not always as accurate as I would like. My sugars can drop extremely fast and with hypoglycemic unawareness, I have had several instances where I pass out, before being alerted by my CGM. Thankfully, I have had mostly desk jobs, but when I’m needed to get up and put patients in rooms or deal with workplace changes (emergencies), my sugars also plummet.

    At a job I had last year, I tried telling the Dr. I was putting patients in for, that my blood sugar was 38 and I needed to sit and eat or else I wouldn’t be able to room his patients. He told me to, “get up and get the patients in the rooms!” Chip-munking glucose tabs, I attempted, while moving slowly, to accurately write down patient’s at-home medication lists for the office’s medical records, obtain and write down vital signs and medical histories…all while having a 38 glucose. This occurred several more times. Eventually the employer made it so difficult for my health to work there, that I turned in my resignation. This has happened over and over again, first starting even during nursing school (1997), where 2 of my instructors gave me insulin when I was “acting weird” during class. I know it’s mainly a lack of education, but when employers turn roles, and write one up for something completely different in order to get “the problem” out of the workplace, it makes it very hard to continue finding employers that will work with you…or so I have found.

    After being laid off this past February, I have had several lows at the grocery store where I work part-time. I feared being fired for my frequent lows. Although I’m on an insulin pump…I can’t seem to find the right dosage of insulin. I was advised by the paramedics to get FMLA papers so that they couldn’t terminate me, although I had an RX stating that I needed frequent and regular breaks. So far it’s working, but the stress is still there…my breaks are still being skipped when we’re busy, and lunches frequently overlooked, even when I question the supervisors. What if I happen to find job where breaks aren’t offered during every 4 hrs, or if I feel low, but it’ll cause havoc to the entire work routine? I don’t like to draw attention, but my Type 1 diabetes seems to do just that. - Fearful in Ks.

    Posted by Carrie |
  15. Untill 15 months ago I worked at a small gas station/convience store owned by a huge corporation and I was always penalized for checking glucose levels, eating when needed and taking meds. I usually had to do these things while standing at the cash register taking care of customers, most of who were very understanding and patient about it. The corporation was not. To bad I didnt know about the ‘reasonable accomodations’ at that time.

    Posted by Brenda |
  16. I have lost two jobs due to my Type 1 diabetes. One was due to a perceived inability to perform my duty (as a ski instructor) and even though I provided a doctor’s letter stating that there would not be any issues, I was still replaced. The other job loss was due to my complaint to HR (of a large corporation) that I need to be able to sit down while working. I was working in a very fancy spa, and I asked my supervisor for a tall stool to rest my legs with, but was told that it was not possible. From that point on she looked for and created reasons to get rid of me. This was a truly distressful situation, which only made my diabetes go out of control since she was breathing down my neck at every chance she got. Once the diabetes was out of control, well, you know, my job performance plummeted. I was pretty traumatized by the whole situation, and was extremely glad when I was let go. It did all end up turning out for the better, since I now have an excellent job, working from home, on what ever schedule I choose, but at the time, it was not fun. I wouldn’t wish diabetes discrimination on anyone.

    Posted by mimic |
  17. Lo! Am grateful for this topic. I have been a victim. I am type 1 diabetes and work in local NGO. Am a programme staff, this means moving a lot in remote areas in Kenya.Either in the office or at field we are always very busy and therefore no time for checking BG. We are also provided lunch in the office but with no consideration of any one who requires to have special diet.I have been thinking through about it as far as my health is concerned but what do i do. This is a private sector, I cannot afford to loose the job for now, Though am suffering but at least i can afford to cater for my medication as we are covered. I pray that one day we will be able to address the issue in all nations and there could be rights for people diagnosed with diabetes.

    Cheers!

    Posted by Hannah Wambui |
  18. Diebetics in the work place is very stressful I have been on probation for the last 4 months for making errors and our new time clock My employer watching me like a hawk and that just make my blood sugar whacky then more errors I work in a small office and my employer says with a small office someone is always going to be left out of course that is me I have not been let go yet but its coming to that I can retire next April I hope I last that long but it all to stressful for my health I just do not feel good

    Posted by Bon |
  19. I have not yet been discriminated against but feel the pressure of what could and most likely would be discrimination in a new job I am looking into. I am 18 years old, was just diagnosed this year with type 1 diabetes. My cousin wants to get me this job at a restaurant as either a bus boy, waiter, or barback, but I feel like it’s basically impossible for me to work at this kind of a place anymore. I used to work at a restaurant for 2 years from age 15 to 17 but that was before I was diagnosed. Now I feel that it can’t be done, I have to shoot insulin in the morning before breakfast, then by the time lunch time comes I NEED food or my sugar will definitely be low and I’ll feel it right away, but what if it’s too busy that day until 3pm, 4pm, even 10pm? I can’t do it. Plus the fact I need to shoot insulin again before dinner, and with this kind of a job I could be working until 2am and 3 am with non stop business and no time for shooting insulin and taking breaks to eat. It’s stressful and has narrowed down my future career choices but I confide in the Lord Jesus Christ he gets me through everything one way or another and I keep on praying to God to lead me down his path and his path only, and I confess all my shameful sins and wish I could take them back. I also realized from the beginning that God has given me this cross to bare with strong reasoning and I know it. I can feel it in my heart that there is a good reason for it along with everything else he puts in front of me and all of us in our lives. I thank God for his blessing and I ask of him that I will be able to maintain a healthy lifestyle, maintain being a man of God, and be successful in my life. And I know that God will get me through all the struggles to get where he wants me to be as long as I be the man I am supposed to and praise the Lord, spread his word, and be kind to his people and creatures as much as I possibly can be.

    Posted by Ralph |
  20. My has worked for a large company in our area for 3 yrs. He worked as a f/t temp for 18 mos., and then was hired and has been there now for a total or 3 yrs. He has had Type 1 diabetes for 33 of his 39 yrs, and they knew that when they hired him. He works 6 pm-6 am 3 days on, 2 off, etc, and it’s hard work. The environment is hot, and miserable, but the pay is good, and he works with some guys he’s known since grade school, so they can tell if he starts to get low, and they make sure he gets sugar. Anyway, 2 wks ago, he had a bad low blood sugar in the street outside of work, before he even got in the bldg, and had to be taken to the hospital because his temp had dropped to 90* (that’s never happened before), and they weren’t able to get IV’s in and his blood sugar was around 30. Anyway, they now have him on “probation” until he can get his “diabetes under control”, even though his Dr. cleared him. The company wants “guarantees” that it won’t happen again???? Who can guarantee that ANYONE won’t have a health scare in 3 yrs? They have now moved him to a crappier job where he will stand in one place for 8 hr shifts,with people who don’t know him at all, and he will be making about $400/mo less. Can they do that?! I’m so angry, and he doesn’t know what to do. Just had to vent…thanks. Just seems like discrimination to me. He has fantastic sales and customer service experience, and the company is huge, with those types of jobs available. If he’s such a threat in the plant, why not value him enoug to put him in one of THOSE jobs? So frustratingf! Thanks for listening, and I’m so sorry for you all who have dealt with this, too

    Posted by Sondra |
  21. Sorry, my first sentence in my above post should read “my son”. I’m old and stressed, what can I say :D !

    Posted by Sondra |
  22. Diagnosed with diabetes last June (2012). I already started cutting sugar out two months previously, and was bounced here and there to specialists. I nad little say in the matter, and that interfered with my job search. The kidney stones in September didn’t help either. I noticed that once I started controlling my diet for sugar, I was able to settle out my moods: i was mis-diagnosed with depression. I think my poverty had something to do with that. In Canada, things are changing, but I understand that there are safeguards in place, but you have to self-advocate. What I have done is been up-front with diabetes and I just tell employers, “You don’t want me dying on the job and adding to paperwork, here are the minimal accomodations. I’ll let you know if I get into trouble. Unless you don’t think I should take care of myself…”

    Posted by Adrian |
  23. I believe there needs to be grants so diabetics can start up businesses that allow them to manage their illness and time that it consumes. Most diabetics are very intellegent people.They don’t have very good credit scores because it is ectra hard to work, manage credit, and maintain employment. Sometimes Diabetics even default on college loans because of their unstable health conditions. When diabetics are doing gfood they can finish short term programs quickly but long strefful classes usually become W’s or they never make it to the exam even though they had learedn everything in the class. I am a diabetic. Actually its a form of Modey. Which is a latent form of high blood sugar that came on in my 20s. I have always been an athlete, and never ate very bad. I actually sometimes wonder if it is some big conspiracy to reduce the population through our food or vaccines, maybe all the flouride in the water or chemicals in our foods and drinks that has caused the explosion of a diabetic population. Anyway, it is like I need some answers and it is a maze of people trying to rationalize the severity of diabetes and tone its severity down. Its an auto immune disease like Lupis, or RA or MS, but they dont want you to realize that as a society. When it comes to work, and even things like graduate school can be one hell of a struglle even for a single diuabetic without a family that depends on him or her. I am in my late 30s now and I still have not been able to find an employer to pay me a decent wage, make accomidations, or even hire me as a diabetic. Anything under $60,000 a year in the current 2013 economy is hard for anyone to live off of, but can you imagine the medical and healthy food requirements for diabetics. Diabetics need enough to live off of as a diabetic, maybe raise a family, and even run a business. Because typically self employment is the only way a diabetic can go, but there is never any funds to assist the avarage diabetic. I was told I could not fly ATP as a pilot after finishing fight school ($90,000) because my sugar, even on medicine and insuline. My levels go from the mid 250s to 50s-60-s very quickly sometimes. When they do I get shakey, nervous, moody, confused, and I have to lay down and recover. It can take days sometimes because a unbearable migraine usually follows. The hardest part for doctors is that I look healthy,and attractive, and its hard for Dr’s to understand I can not hold a job, simply because there is no way to get the training I need. Training is designed to put most people through the riggors of a job at its hardest, usually you cant miss more than 3 days, and a program I just applied for is 5 years long. I already know I will never make it. Its just the way I know my body works as a diabetic. There is no real way to control the sluggishness and the infections in my sinuses. When my sugars are normal, I have no energy and I am forgetfuill. I need a job that will give me the life I need to manage my eating, exercise, and safety. I feel sick at least part of the day. Moody, shakey, at times. Then at times I can go and play a game of catch or mow the lawn just fine. Everytime I think I may be able to break into a writing or movie making career, I can not come up with the funds needed. Trust me folks, its time society moves on and quits treating workers like slaves and moves to a more community based way of economic means. We have to rid ourselves of foreign banks, central banking, and credit monitoring systems. We have to remove the concept of qualifications and licincing for employment. Its not just for diabetics, its for what we have done to our civilazation as a whole. In essence we have enslaved it, made it in debt and handed it over to controling people who care less how much humanity suffers. Especially diabetics.

    Posted by Orlando Voter |
  24. I have an employee who is diabetic. She tests her sugar and gives herself insulin shots daily. She is very open about having diabetes, and takes every opportunity to educate others on the subject. Another employee who works with her has lately (she’s only recently began to ask about this, and she’s worked with this employee for over 4 years) begun to complain that she takes her insulin shots publicly. She says she’s worried that patrons will be offended by seeing this, or will wonder if she is administering illegal drugs, or that they may try to steal her needles (which she puts in her purse and takes home to dispose of). She can easily do this in a private place, and I believe she could do it as needed. Do I have the right to ask her to take her insulin shots in private rather than in public?

    Posted by Ginger |

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Living With Diabetes
Patterned Behaviors (08/14/14)
Toughen Up, Kids (08/07/14)
I've Said It Before… (07/31/14)
An Introduction (06/25/14)

 

 

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