Diabetes at work: time for action

Diabetes is a hidden epidemic among both the general population and the workforce.

If workers are suffering from diabetes, their employer can potentially be exposed to problems such as higher rates of absenteeism, an increased risk of accidents and potential legal liabilities in the event of an incident if a worker with diabetes is either hurt or places others in danger due to the symptoms of the condition.

There is also a growing understanding among employers of the human and business benefits of supporting all aspects of worker wellbeing, including supporting employees with diabetes.

For example, educating workers about the symptoms of diabetes can encourage those who are unaware they have the condition to seek a diagnosis and advice on managing (or even putting into remission in some circumstances), their diabetes from their doctor.

In turn, this can prevent undiagnosed diabetes from silently and unknowingly causing serious health damage to the individual. The health damage can include damage to the eyes, heart (when damage to blood vessels leads to heart attacks and strokes), and feet, (when nerve damage and damaged circulation leads to amputation of the foot or leg).

Also, ensuring that diabetes is diagnosed and managed will reduce the impact of the condition on the person’s general health and wellbeing. This could potentially improve the individual’s productivity and performance at work – for instance, because they are less likely to suffer symptoms like blurred vision and feeling disoriented that could affect how they feel and perform.

Currently, it is estimated that one in 12 people in the UK (aged 20-79), have diabetes, and one in three are thought to be ‘pre-diabetic’. Photograph: iStock

If an individual has diabetes and is aware of this fact, better self-management of the condition could also bring benefits such as fewer days off work. For instance, a worker might previously have taken time off after attributing the symptoms of undiagnosed diabetes to a general sense of ‘feeling unwell’. However, after diagnosis and help in managing their diabetes from their doctor, they may be more capable of preventing the symptoms of diabetes from arising. In turn, this will reduce the need for them to take time off due to the symptoms and health impacts.

In addition, educating workers about the causes of type 2 diabetes – and how to self-manage the condition through lifestyle measures like maintaining a healthy weight, following a healthy diet and exercising – can help those with diabetes to better manage the condition and its symptoms. It can also reduce the risk of diabetes complications damaging the individual’s health in the longer term, such as by reducing the risk of the individual suffering cardiovascular disease.

Also, good education by employers will encourage staff to make lifestyle changes that will reduce their risk of developing diabetes in the first place – with associated benefits for the workers’ health and productivity.        

Rising number of cases

The UK (and the world) is seeing an inexorable rise in the number of people with diabetes, and this will inevitably have an impact on employers as the proportion of the workforce with the condition also increases.

Currently, it is estimated that one in 12 people in the UK (aged 20-79), have diabetes, and one in three are thought to be ‘pre-diabetic’. This is where the person’s blood sugar level is higher than normal, placing them at high risk of developing type 2 diabetes, the most common form of the condition.

It is predicted the number of people with diabetes in the UK will increase from the current level of 4.6 million to 5.5 million by 2030. Worryingly, around one million people in the UK have diabetes but are unaware and undiagnosed.

Also, people are increasingly developing type 2 diabetes at an earlier age, meaning a large proportion of people living with diabetes are of working age and can be found in the workforce. It is also predicted the proportion of people developing diabetes at an earlier age will continue to increase.

Kate Walker is CEO of the Diabetes Safety Organisation

For employers, the data around the potential impact of diabetes on their workers (and potentially health and safety risks at work), is alarming.

For every 1,000 employees, it is estimated 82 will have diabetes and 25 will be at risk of a ‘hypo’ event due to their diabetes. This potentially translates into an estimated 49 mild to moderate hypos per month, and two to five severe hypos, each month in the workplace.

A hypo, also called hypoglycaemia, is where the level of sugar (glucose) in the blood of a person with diabetes drops too low. A hypo can cause various symptoms, including appearing intoxicated, a sudden loss of consciousness, shaking, blurred vision and feeling disorientated. If a worker experiences a hypo, they may require assistance from another worker and a member of the public, such as calling an ambulance or helping the person to restore their blood sugar level by providing suitable food or drinks.

Clearly, a severe hypo can pose serious health and safety risks at work – for example, if the worker suffers a hypo while operating plant or machinery, or when driving.

Impact on productivity

However, as well as a hypo posing a health and safety risk, non-severe hypos can have a significant impact on worker productivity and wellbeing. For instance, research has found that after experiencing a non-severe hypo:

• 30 per cent of people arrived late to work, on average two hours and 45 minutes late
• 21 per cent left work early, on average two hours and 30 minutes earlier
• 12 per cent missed a full day or more, on average missing four days
• 36 per cent missed a deadline or rescheduled meetings
• 28 per cent avoided driving.

This soon adds up. In fact, it has been estimated that in a company of 1,000 people, 204 hours per month (51 hours a week), are lost due to missed or lost work from non-severe hypos.

Given the rapid growth in the number of people being diagnosed with diabetes, this is alarming. Also, the estimated loss of 261 hours does not include time lost due to lower productivity while at work – such as missed meetings and deadlines, lower quality work, and the need to repeat work because a hypo has interrupted a task – either for the sufferer or those who had to come to their aid.

One possible reason why many employers fail to think about and address the possible workplace safety risks arising from workers with diabetes is that the contribution of hypos in causing safety incidents is rarely considered or recorded in incident reports and statistics. However, if a worker does experience a hypo while carrying out tasks like operating dangerous plant, machinery and equipment (or while driving), the consequences can be serious and life-threatening.

Getting started on diabetes safety and diabetes awareness

So, what kind of steps should employers be taking to minimise the health and safety risks from diabetes, ensure workers understand the risk diabetes poses to their health, support workers so they feel comfortable revealing they have diabetes (and feel encouraged to seek a diagnosis and support), and ensure the business is playing its part in preventing cases of diabetes in society?

In short, employers should draw up and implement a diabetes safety plan. Among various things, this will generally include steps such as:

• Training and educating staff about the causes, symptoms and health consequences of diabetes
• Creating an open and non-judgmental environment so workers feel comfortable revealing they have diabetes, so the employer can make any necessary adjustments, like allowing the individual adequate breaks and time to test their blood sugar levels and take injectable medications
• Providing an appropriate place at work for staff with diabetes to test their blood sugar levels and take injectable medications
• Educating workers about the potential health and safety risks if someone with diabetes suffers a hypo
• Thinking about possible risks arising from diabetes when carrying out health and safety risk assessments at work, and taking any necessary control measures – for example, a requirement for a worker to test their blood sugar before operating high risk plant or machinery.

If members of the workforce have diabetes, it also makes sense to train colleagues so they know how to identify and help if someone experiences a hypo. This could mean, for example, ensuring colleagues understand how to provide glucose or dextrose tablets to restore the person’s blood sugar to a safe level.

This knowledge is important, as recent analysis has shown that during a severe hypo:

• 35 per cent of hypos were reported by another person, rather than the person experiencing the hypo
• 23 per cent of people experiencing the hypo were informed by someone else that they were having a hypo
• 21 per cent of people who experienced a hypo were found unconscious by another person.

Through education and awareness-raising, employers can also play a major role in preventing cases of diabetes in the wider population in the first place. They can also play a part in encouraging those with type 2 diabetes to better manage the health impacts and symptoms of the condition and to prevent or reduce the risks of the associated health complications (like blindness, heart attacks and strokes).

This can be achieved by educating and encouraging workers to take steps like eating more healthily, increasing physical activity, losing weight and stopping smoking, all of which can help manage the health impacts of diabetes.

For example, the Diabetes Safety Organisation has developed the ‘One Less Challenge’, which aims to both help prevent cases of type 2 diabetes and help type 2 sufferers to minimise the health impacts of the condition. 

This essentially means encouraging people to reduce, in an achievable way, the intake of foods known to increase the risk of either developing or suffering the health impacts of type 2 diabetes.       

Although many of us are aware of the public health advice on the benefits of a healthy diet and exercise, we often fail to follow it, for various reasons. The ‘One Less Challenge’ essentially means that rather than someone cutting every food they like out of their diet, or making massive dietary changes that aren’t sustainable, they instead strive to have one less of something. For example:

One less sugar in their tea/coffee which, when spread across six cups in a day, means one kilogram less of sugar a month or 12 kilograms less a year
One less biscuit three times a week, which adds up to approximately 5.5 packets less a year.

So, simply having one less of something will have a significant, positive impact on people’s blood sugar levels and their overall health.

At the Diabetes Safety Organisation, we have found the ‘one less approach’ often works well in industry, particularly male-dominated industries. It is therefore a simple, low-cost educational approach that all employers can adopt to encourage staff to live more healthily. In turn, this will help prevent cases of type 2 diabetes – and reduce the health impacts for those already diagnosed with type 2.

Future developments

Clearly, the issue of diabetes safety and the education of staff around the risk diabetes poses to health, safety, quality of life and life expectancy is not being fully addressed by all employers.

However, there is a growing understanding among businesses, trade bodies, the government and politicians that more can and should be done at work to prevent diabetes, support those with diabetes to better manage the condition and protect their health, and to manage the workplace safety risks from diabetes.

For example, the Diabetes Safety Organisation has launched the Tackling Diabetes Safety Charter, which aims to support companies to protect their staff from diabetes risks. By signing up to the Charter, companies commit to taking steps such as increasing employees’ understanding of the causes, personal health impacts and work-related safety risks from diabetes; removing the stigma so staff feel comfortable disclosing their diabetes; assessing and controlling the work-related health and safety risks from diabetes; and providing diabetes first aid kits at work to enable the fast treatment of hypos.  

Later this year, an MP intends to pose a Parliamentary question highlighting the role the charter can play in reducing the safety risks from diabetes and supporting the health of employees with the condition.

Kate Walker is CEO of the Diabetes Safety Organisation

To mark Diabetes Week, in June 2022 Being Well Together ran a free webinar on diabetes safety at work. The webinar was delivered in partnership with The Diabetes Safety Organisation and Gowling WLG law firm. Listen to the recording here