Having diabetes can interfere with certain occupations, but there are ways to find and keep a job that’s right for you. Here are some expert tips on finding the right position, balancing work and life, asking for help, and more, from an employee rights attorney and a physician with Type 1 diabetes.
What’s a good job?
Diabetes influences what jobs are best to work. Here are some things to think about:
• Regular schedules are best. Dr. Alan Glaseroff, a physician with Type 1 diabetes, says “Try to avoid shift rotation. It throws off your insulin, food, and exercise schedule.”
• Stressful jobs aren’t good, as stress raises blood sugar levels. In addition to emotional stress, stress can include physical hardship such as working in extreme cold or extreme heat.
• It’s important to be aware what kind of health insurance, if any, a job provides.
• It is also important to know if breaks are allowed. Managing diabetes requires occasional breaks for checking blood sugar, eating, or take medication. A warehouse worker told me, “At my job, you get one paid break in nine hours. Most people skip the unpaid break and just keep working. My diabetes has been out of control since I started.”
• Larger companies might be better, because they are covered by worker-protection laws. The Americans with Disabilities Act (ADA) requires employers with over 15 workers to provide “reasonable accommodation” for disabilities, including diabetes.
The Family Medical Leave Act (FMLA) assures that workers get unpaid time off for health needs such as doctor appointments and self-management training, but it only applies to companies with 50 or more employees within 70 miles of your place of work. According to San Francisco–based employee rights attorney Alan Adelman, jobs with union membership may provide an extra layer of protection.
Under the ADA, no employer of any size is allowed to discriminate against you, though small ones are not required to accommodate special needs.
See if you can look around the job site and talk privately with employees about what it’s like.
Applying for jobs
Attorney Adelman says don’t volunteer information about your health. “An employer can’t ask you if you’re disabled,” he says. “That’s an invasion of privacy, but they can ask you if you’re able to do the job.”
Some employers may ask if you have diabetes, because of fears of raising their health insurance costs. They are not allowed under the ADA to refuse to hire you because of diabetes, but it’s hard to prove discrimination.
Focus on how well you can do the job. Ask for accommodations after you’re hired, or after you’ve cleared the probationary period.
Chronic conditions such as diabetes are considered disabilities and entitled to accommodations. But you have to tell the employer about your needs to get them met.
Former administrative judge Joan Herrington says, “Cases often turned on notification. Was the employer notified in a timely manner?”
It can be scary, and risky, to ask for accommodation. Herrington heard cases where, after requesting accommodation, employees were subject to stricter evaluations and received undeserved negative reports. It helps if you can negotiate with supervisors in a friendly way.
“Accommodations cannot be burdensome to the employer,” says Adelman. “Diabetes accommodations are usually not considered burdensome: A five-minute break and a private place to inject are not burdens.”
Diabetes can mean longer recovery times from illness, accidents, and surgeries, and Herrington says it’s important for doctors to give you enough time. Otherwise, you might need repeated leaves, which are more likely to burden employers and get you in trouble.
Personal relationship with employers counts for a lot in getting through sticky accommodation issues. Alan Glaseroff says, “Manage your boss. Be nice to them even if you hate them. Compliment them any time you can find a reason to. Don’t go up against the boss in front of people. Do it in private.”
Be creative in suggesting accommodations that might work for you. Some workers in places that didn’t allow for breaks agreed to work 15 minutes later to make the time up. Some who were told to cut hedges in hot noonday sun negotiated a way to work earlier and do lighter work in the afternoon. For desk jobs, it may be possible to negotiate working from home.
Avoiding lows and highs
Workers’ low blood sugars are employers’ worst diabetes fear. Employees may make mistakes, cause accidents, or simply be unable to work because of lows. Avoid lows as much as possible. Dr. Glaseroff says, “I always have protein for breakfast and try to have it at every meal. I carry glucose tabs in my pocket and take them whenever needed.”
Highs are also a risk. “Particularly if a job is stressful, or if sleep is interrupted, sugars can go high quickly. I advise frequent checking of sugars, especially if your pattern has been disrupted by travel or work. I also caution patients, don’t treat a low with a bowl of ice cream.”
Some jobs may not give you the privacy and time to test frequently, but faster, less obtrusive testing options are now available. A continuous glucose monitor means you don’t have to test at all (except for calibration), and skin patches for monitoring are now available in the UK and soon will be here.
Carry and nibble snacks that won’t attract attention and that include some protein.
Balancing work and life with diabetes
Dr. Glaseroff has had a rich career, but he has given up some opportunities because of diabetes. “I would have liked to run off and work with Doctors Without Borders somewhere,” he says, “but I realized it wasn’t a good idea.”
Some people with diabetes go all out in their careers, whether as athletes, performers, business people, or whatever. While there is no work that diabetes prevents you from doing, you must fit in time for self-management, rest, exercise, proper eating, and monitoring. If you don’t, your career may be cut short by diabetes complications.
Put your diabetes needs at the top of your daily to-do list, so you don’t forget them.
When to get help
Sometimes you will want advice on how to handle a diabetes work situation. You can get help from the following resources:
• A worker’s rights attorney — they can be found with a Web search or in the Yellow Pages. Many will give you free advice. You might go to your local Legal Aid Society for free advice or low-cost representation.
• Your union may have lawyers or advocates who can help you.
Attorney Adelman says, “Don’t wait too long to get advice. An ounce of prevention is worth a pound of cure. Get early input and guidance, before making decisions or creating documents.”
The American Diabetes Association can steer you to help, even when they can’t provide it themselves.
Alternatives to jobs
Not everyone has to work at a conventional job. Alternatives include working from home, self-employment, getting benefits, or some mix of these means. A job that fits your life is a blessing, though, and worth pursuing for many people with diabetes.
Want to learn more about working with diabetes? Read “Diabetes on the Job,” “Making a Living With Diabetes: Job Problems,” “Making a Living With Diabetes: Working From Home,” “Making a Living With Diabetes: Disability,” and “Making a Living With Diabetes: Monetizing Your Life.”