Diabetes is a condition which affects the pancreas and its ability to produce a substance called insulin which regulates the sugar levels in the blood. There are two types of diabetes. Type 1 usually develops in childhood, unrelated to lifestyle, whereas type 2 is linked to obesity and other conditions of poor health. It is estimated that nearly 4 million people in the UK have diabetes, 90% of whom have type 2.
What are the signs and symptoms of diabetes?
Type 2 diabetes can be preceded by high blood sugar (glucose) levels, but which are not enough to be considered diabetic. This is known as pre-diabetes and can usually be stopped from developing into full-blown diabetes with dietary improvements and weight loss.
Symptoms of diabetes include:
- Feeling constantly thirsty
- Urinating more often
- Weight and muscle loss
- Genital itching
- Blurry vision
- Slow-healing wounds
These symptoms can develop in a matter of weeks in the case of type 1 diabetes, whereas their onset is much slower and can be barely noticeable for years in people with type 2.
Some expectant mothers experience elevated blood sugar during pregnancy, called gestational diabetes, which then goes away once the baby is born.
How is diabetes diagnosed and treated?
Type 1 diabetes can be diagnosed with a urine test to detect elevated levels of glucose. This indicates that the immune system is destroying the cells that produce insulin, meaning the body cannot regulate blood sugar levels. A blood test can confirm suspected type 1 diabetes.
Treatment involves regular finger pricking to test blood glucose levels and injecting insulin if required. Some people use a pump which adds insulin straight into the bloodstream when detected blood sugar indicates that this is necessary.
Insulin can be taken once or twice daily to keep insulin levels stable between meals and overnight. Fast-acting insulin can be taken after a meal or carbohydrate-rich snack to stabilise blood sugar, which rises after eating.
Type 2 diabetes can be diagnosed in the same manner, but instead of insulin injections, it is managed with medicine to keep blood sugar stable. This is in conjunction with diet and lifestyle modifications, such as more and regular exercise, regular balanced meals and cutting down on sugar, fat and salt.
There are a few ways to confirm what sort of reasonable adjustments should be made for an employee with diabetes:
An employee may not disclose their diabetes upfront, but if they do, questions regarding the nature of an employee’s diabetes and what extra support they may need can be broached sensitively. For example:
- Have they required adjustments in the past? For example, permission to take breaks at the same time every day to administer insulin, as opposed to according to changing shift patterns.
- Encouraging the employee to express their strengths and interests and which tasks they might enjoy doing is a positive way of adapting to their needs and empowering them, in spite of their diabetes.
- Even if the employee does not wish to disclose their diabetes – or they have not even received a precise diagnosis – an employer can focus on making reasonable adjustments, rather than seeking to determine the precise disability their employee has.
What reasonable adjustments are possible for employees with diabetes?
Employers have a legal duty to make reasonable adjustments for employees with diabetes if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has diabetes. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.
If the employee does not disclose a health issue or disability which may affect their performance upfront, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of diabetes:
- Flexible working hours to accommodate medical appointments and fatigue – an effect of diabetes for some people.
- Additional breaks, to allow the employee to have a snack or inject their insulin if this is necessary for their blood sugar at a specific time that does not otherwise coincide with a timetabled break.
- Adjustments to duties depending on the severity of their symptoms. For example, someone with diabetes may have reduced vision (known as diabetic retinopathy) which may mean they cannot operate machinery.
- Raising awareness so that colleagues understand the employee’s diabetes and can help ensure the employee feels comfortable at work, for example, when injecting their insulin.
- Prevention of type 2 diabetes, such as by adapting the workplace culture of bringing in sugary cakes and biscuits to share round, which can lead to weight gain and insulin resistance – which causes type 2 diabetes. It is in the employer’s interest to keep the workforce healthy, to save money spent on sick pay, for example.
Diabetes UK – charity working to prevent type 2 diabetes, campaigning for better treatment of all diabetes and funding research that aims to find an eventual cure for diabetes (0345 123 2399).
Juvenile Diabetes Research Foundation – charity researching cures for type 1 diabetes, campaigning for improved treatment and giving a voice to people with type 1 diabetes, as well as supporting them to live with the condition (020 7713 2030).
Diabetes Research and Wellness Foundation – organisation funding research into treatment, prevention and management of all diabetes, as well as providing support to people living with the condition (023 92 637808).
Other Research Resources