The five business risks of the Type 2 diabetes epidemic

Diabetes is a complicated and frequently misunderstood condition. Type 2 diabetes is often not considered as serious a condition as Type 1 diabetes or other conditions such as heart disease, stroke and cancer. Most employers are not aware of the prevalence of diabetes in their workplace, how their workplace might be contributing to diabetes, or the threat of the Type 2 diabetes epidemic on business performance, growth and sustainability.

Photograph: The Diabetes Safety Organisation

Type 2 diabetes is a public health emergency in the UK. It is the leading cause of blindness in the working-age population, there are 190 amputations and around 500 people die prematurely each week in the UK from diabetes. People with diabetes have a higher risk of 57 other health conditions, including heart disease, stroke, cancer and kidney disease.

Many employers are unaware of how the workplace can contribute to developing diabetes and how workplace factors often significantly compromise an employee’s ability to manage the condition effectively. Employees with diabetes largely manage their condition in ways which minimise its visibility – for example, by not taking medication in front of others or by not talking about the condition. Health and safety incident reporting does not record where diabetes has been a factor in workplace safety incidents. The Type 2 diabetes epidemic poses a significant threat to workforce productivity and safety, and may expose employers to substantial regulatory risk.

Five million people in the UK have diabetes – that’s one in 12 working-age people. Around 90–95 per cent of people with diabetes have Type 2 diabetes, a largely preventable condition. Type 2 diabetes is a national epidemic, having increased 60 per cent in the last decade. By 2030, one in 10 working-age people will have diabetes and, by 2045, it will be one in eight. In addition, more young people are now developing Type 2 diabetes.

Kate Walker is chief executive of The Diabetes Safety Organisation. Photograph: The Diabetes Safety Organisation

In fact, for every 1,000 employees in the workplace, an estimated:

• 82 employees have diabetes
• 19 employees have undiagnosed diabetes, increasing the likelihood of complications and poor health outcomes
• 350 employees have pre-diabetes
• There are one to three severe ‘hypos’ per month and 20 mild-moderate hypos.

Workplace factors – including access to healthy food, activity levels, stress and shift patterns – can significantly contribute to developing diabetes. Also, for people with diabetes, their ability to manage the condition effectively and prevent complications can be influenced by the same factors at work.

Top five business risks of diabetes

1. Hypos and hypers can cause significant safety incidents. Hypos (where the level of sugar, i.e. glucose, in the blood of a person with diabetes drops too low), and hypers (where the blood sugar level becomes too high), can impair balance, coordination and concentration. Severe hypos can cause seizures and loss of consciousness. For every 1,000 employees there will be an estimated one to three severe hypos happening in the workplace per month. 45 per cent of employees said they would not know what to do if a colleague was experiencing a hypo or would only know general first aid principles. For drivers, not managing diabetes effectively can make them 30 per cent more likely to have a road accident than drivers without diabetes – and the prevalence of diabetes in people who drive for a living is double that of the general population, making workplace interventions and education for drivers extremely important.
2. Hypos and hypers reduce worker productivity. Employees with diabetes are estimated to be absent from work an additional two to 10 days per year compared to employees without diabetes, at a total cost of around £1 billion. The cost of presenteeism (reduced output at work) is significantly greater at £3-4 billion. In the workplace, mild and moderate hypos alone result in 104 hours of lost productivity per 1,000 employees per month, or £1,800 per month at average earnings.
3. Workplace practices may directly contribute to diabetes and diabetes complications in employees. An estimated 75 per cent of employees with diabetes may be acting against their doctor’s recommendations to maintain productivity at work (for example, by reducing their medication dose to keep their blood glucose levels higher than recommended to try to avoid hypos at work), risking their long-term health and employability. Only 48 per cent of people with diabetes attend their regular diabetes checks, with lack of ability to take time off work frequently cited as a contributing factor. 63 per cent of employees with diabetes describe their line manager as unhelpful or unsupportive of their diabetes.
4. Diabetes leads to early workforce exit and loss of skills. An estimated 38 per cent of employees with diabetes aged 45–64 exit the workforce early due to diabetes complications. In a workforce of 1,000 people, this could be equivalent to losing 14 highly skilled workers in the 45–64 age group each year to diabetes complications.
5. Employers are legally required to manage diabetes in the workplace. Diabetes is a known and foreseeable risk in the workplace. Employers must comply with relevant laws and regulations, including the Health and Safety at Work etc Act, the Equality Act and DVLA driving regulations. Failure to manage diabetes may lead to a criminal conviction and unlimited fine for the employer.

What is Diabetes Safety?

There is a clear business case for employers to ensure a ‘Diabetes Safe’ workplace. While many employers already provide health, wellbeing and occupational health support to individuals with or at risk of diabetes, a Diabetes Safe workplace is one that goes further to mitigate the business risks of diabetes, including safety, presenteeism, absenteeism, early workforce exit and regulatory compliance risks.

A Diabetes Safe workplace is one which has taken reasonable and practicable steps to:

• PREVENT diabetes in the workforce
• SUPPORT employees with diabetes to manage their condition effectively while at work
• PROTECT against the business risks (safety, productivity, regulatory compliance) of diabetes.

In a Diabetes Safe workplace, there is clear support by leadership and management for effective management of diabetes in the workplace and a culture which encourages disclosure by those reluctant to reveal they have the condition. In a Diabetes Safe workplace, employees with diabetes experience understanding and support for their condition, rather than feeling it is a private responsibility for which they must compromise effective diabetes management to ‘fit in’ at work.

Diabetes Safety is simple and cost-effective to implement and the performance, growth and sustainability benefits of a Diabetes Safe workplace significantly outweigh the costs.

Becoming a Diabetes Safe workplace

Most workplaces can adopt three simple steps towards becoming a Diabetes Safe workplace.

Step 1 – Sign the Tackling Diabetes Safety Charter

Becoming a signatory to the Tackling Diabetes Safety Charter demonstrates the commitment of senior leaders and the organisation to diabetes prevention and management.

It is an important step towards ensuring a workplace culture that enables disclosure and support for employees living with diabetes. 

Step 2 – Do the Diabetes Safety self-assessment 

DSO has developed a self-assessment tool to enable businesses to assess their current workplace practices, environment, policies and culture against Diabetes Safe criteria.

DSO also provides an employee survey which collects baseline data on diabetes risk in an organisation’s workplace.

Step 3 – Supplement or adjust workplace practices as necessary  

DSO can support businesses to put in place additional measures such as training and awareness campaigns as necessary to achieve Diabetes Safe status.

Businesses which meet the Diabetes Safety standards can use the Diabetes Safe quality mark.

Employers have a business and moral imperative to address the risks of diabetes in their workplace. They are uniquely positioned in terms of the influence and potential impact they have on the lives of their employees and the motivations of individuals for preventing diabetes and diabetes complications.

By joining forces with the government, health sector and civil society, business can help to create the catalytic and systemic change necessary to turn around the diabetes emergency in the UK.

Quick check: Do you know your workforce risk?

• Are employees with diabetes comfortable to disclose their condition to their line manager/HR?
• Are employees with diabetes compliant with DVLA driving regulations?
• Do current work practices compromise the ability of employees with diabetes to manage their condition according to their health providers’ recommendations?
• Do shift patterns compromise testing and medication? Are there safe, clean, private places to test and medicate?
• Do employees ‘run their bloods high’ (i.e. they intentionally reduce their medication dose to prevent hypos) to prevent negative perceptions of their performance at work?
• Are hypos being identified in health and safety data?
• Do employees understand the risks of undiagnosed diabetes?
• Do employees know how to recognise and assist a colleague experiencing a hypo?
• Are line managers confident in their knowledge of diabetes risks in the workplace and their ability to support employees with diabetes?

The Diabetes Safety Organisation (DSO) provides a short employee survey to collect data on the questions above and help organisations understand their specific diabetes risks. Contact DSO to administer the survey for you.

Hypokits – a simple way to immediately improve your Diabetes Safety

Similar to a first aid kit, a hypokit is a compact, easy to use, kit equipped with three fruit-flavoured, caffein and gluten-free, 60ml glucose shots, ready to tackle hypoglycaemic episodes head-on. They come with a QR code, giving all staff free access to a training course on how to use the kit.

Kate Walker is chief executive of The Diabetes Safety Organisation

Contact the Diabetes Safety Organisation to discuss diabetes safety in your workplace:

diabetessafety.org

[email protected]

@diabetessafety

facebook.com/diabetessafety/

linkedin.com/company/diabetes-safety-organisation/

T: +44 (0)333 577 5735

Diabetes Awareness Week 2024 takes place from 10–16 June.