Creating an inclusive and supportive workplace for employees with diabetes is not only a legal requirement but also a strategic business decision that benefits both employers and employees. With millions of Americans managing diabetes in the workforce, understanding how to provide appropriate accommodations and foster a diabetes-friendly environment has become increasingly important for organizations of all sizes.
The Scope of Diabetes in Today's Workforce
Over 34 million Americans have some form of diabetes, whether it's type 1 diabetes, type 2 diabetes, or gestational diabetes. The impact on the working population is substantial, with approximately 15.3 million working age U.S. adults diagnosed with diabetes in 2018, and these numbers continue to grow each year. The prevalence of diabetes among employed U.S. adults stands at 6.4%, making it a condition that virtually every employer will encounter in their workforce.
The workplace implications extend beyond individual health concerns. Direct costs of diabetes reached $307 billion, including hospitalization, medical care, treatment and supplies, and other costs. For employers specifically, diabetes and prediabetes cost employers and insurers billions of dollars each year in lost productivity and medical expenses. Understanding these statistics underscores why creating supportive workplace environments for employees with diabetes makes both humanitarian and business sense.
Understanding Diabetes as a Workplace Disability
What Is Diabetes?
Diabetes is a group of diseases characterized by high blood glucose or sugar levels that result from defects in the body's ability to produce and/or use insulin. Insulin is a hormone that helps glucose enter the body's cells to provide them with energy. Both type 1 and type 2 diabetes are physical impairments that substantially limit major life activities, including bodily function of the endocrine system, eating, and caring for oneself.
The condition requires constant management throughout the day, regardless of where an individual is located. People with diabetes live with the condition all day, every day, including at work. This ongoing management can include monitoring blood glucose levels, taking medications, adjusting food intake, and responding to symptoms that may arise unexpectedly.
Diabetes as a Protected Disability Under the ADA
The Americans with Disabilities Act (ADA), which was amended by the ADA Amendments Act of 2008, is a federal law that prohibits discrimination against qualified individuals with disabilities. The U.S. Equal Employment Opportunity Commission (EEOC) enforces the employment provisions of the ADA.
Under the ADA, employers with fifteen or more employees cannot discriminate against qualified individuals with disabilities. In some states, additional protections exist. For example, California's Fair Employment and Housing Act (FEHA) bars discrimination by employers with five or more employees.
The ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such an impairment. Diabetes typically qualifies under this definition because it affects major bodily functions and daily activities.
How Diabetes Impacts Work Performance
Diabetes can affect employees in various ways that impact their work performance and productivity. Employees with Type 2 diabetes may experience an 11–19 percent loss in productivity and take more sick days than colleagues. The research on absenteeism is particularly telling: the number of days lost annually from work per employee ranged between 5.4 and 18.1 days for employees with diabetes and between 3.4 and 8.7 for those without diabetes.
Beyond absenteeism, diabetes can affect employment in other significant ways. Among individuals with diabetes, the absolute probability of working was 4.4 percentage points less for women and 7.1 percentage points less for men relative to that of their counterparts without diabetes. These statistics highlight the importance of providing appropriate accommodations that enable employees with diabetes to remain productive and engaged in the workforce.
Common Limitations and Symptoms Affecting Work
Blood Glucose Management Challenges
Individuals with diabetes may need to monitor glucose levels periodically and take appropriate action to ensure stability. Various methods may be used to monitor glucose levels, including lancing devices, apps, and service animals. This monitoring is not optional—it's a critical component of diabetes management that must occur throughout the workday.
Medication such as insulin may need to be stored in an area that is temperature-controlled and quickly accessible to the individual at all times. Scheduled meals or snacks may be necessary. These requirements mean that employees with diabetes need regular access to their supplies and may need to interrupt their work periodically to manage their condition.
Hypoglycemia and Hyperglycemia Episodes
Two of the most serious concerns for employees with diabetes are episodes of hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar). Episodes of severely low blood glucose (hypoglycemia) occur only in people receiving certain treatments such as insulin or secretagogues such as sulfonylureas and even then occur infrequently. However, when they do occur, they require immediate attention.
Some individuals with diabetes choose to disclose their condition because they want their co-workers or supervisors to know what to do if they faint or experience other symptoms of hypoglycemia (low blood sugar), such as weakness, shakiness, or confusion. These symptoms can be alarming to witness and require prompt intervention to prevent serious health consequences.
Secondary Complications
Diabetes can lead to various complications that may require additional workplace accommodations. Individuals with diabetes may experience neuropathy resulting in pain, numbness, and weakness in parts of the body. Vision impairment and blindness may result from diabetes. These complications can develop over time and may necessitate adjustments to job duties or work environments.
Stress can cause a temporary rise in blood glucose levels, which may be detrimental to individuals with diabetes. This connection between stress and blood glucose control means that managing workplace stressors may be a necessary component to accommodating diabetes.
Comprehensive Guide to Workplace Accommodations
Flexible Break Schedules
One of the most fundamental accommodations for employees with diabetes is the ability to take breaks as needed to manage their condition. Breaks may be needed to allow an individual to test blood glucose levels when needed. Such checks only take minutes to complete. These breaks are typically brief and should not significantly disrupt workflow.
Employees might ask employers to allow them to take regular breaks to check their blood sugar, eat a snack, take medications, or use the restroom. The frequency and timing of these breaks will vary depending on the individual's treatment plan and how well their diabetes is controlled. Some employees may need breaks at specific times, while others may need the flexibility to take breaks when symptoms arise.
Private Space for Diabetes Management
Employees with diabetes may require a private area to test blood sugar levels or to take insulin. This accommodation addresses both practical and privacy concerns. While blood glucose testing can be performed quickly, many employees prefer to do so in a private setting rather than at their desk or in view of colleagues.
Blood glucose can be checked wherever the employee is without putting other employees at risk, and employers should not limit where employees with diabetes are permitted to manage their diabetes. However, providing a designated private space demonstrates respect for employee privacy and can make diabetes management more comfortable and less stressful.
Access to Food and Beverages
Employees might ask employers to allow them to keep food and diabetic supplies close at hand. This accommodation is critical because individuals with diabetes may need to consume food or beverages quickly to prevent or treat low blood sugar episodes. Restricting access to food or beverages, or requiring employees to store them in distant locations, can create dangerous situations.
Employers should also consider the quality of food options available in the workplace. Employers can make changes that can help people with diabetes maintain healthy blood sugar levels, for example, provide healthier choices in vending machines and cafeterias. This benefits not only employees with diabetes but promotes overall workplace wellness.
Rest Areas for Blood Sugar Stabilization
Employees may need a place to rest until blood sugar levels normalize. When blood sugar drops too low or rises too high, employees may need to rest in a safe, comfortable location while their glucose levels stabilize. Employers should provide a safe place for employees to rest until their blood sugar normalizes after a hypoglycemic episode.
This rest area should be easily accessible, private, and comfortable. It doesn't need to be elaborate—a quiet room with a chair or couch where an employee can sit or lie down for a short period is typically sufficient. The key is ensuring that employees have a safe place to recover without feeling exposed or pressured to return to work before they're ready.
Modified Work Schedules
Some employees with diabetes may benefit from modifications to their work schedule. Shift work, for example, has been shown to be associated with more frequent uncontrolled blood sugar levels. Rotating shifts or irregular hours can make it difficult to maintain consistent meal times and medication schedules, which are important for diabetes management.
Accommodations might include allowing an employee to work a consistent shift rather than rotating shifts, providing flexibility in start and end times to accommodate medical appointments, or allowing remote work when appropriate. These schedule modifications can significantly improve an employee's ability to manage their diabetes effectively while maintaining productivity.
Storage for Medications and Supplies
Employers should allow for storage of medications, such as insulin and/or food. Insulin and some other diabetes medications require refrigeration, so access to a refrigerator is essential. Employers should ensure that employees can store their medications safely and access them quickly when needed.
In addition to refrigeration, employees may need space to store testing supplies, extra medication, snacks, and emergency supplies. A small drawer, locker, or designated space in a shared refrigerator is typically sufficient. The key is ensuring that supplies are both secure and readily accessible.
Assistive Technology and Equipment
For employees who have developed diabetes-related complications, additional accommodations may be necessary. Employers may need to provide large-screen computer monitors or other assistive devices if employees have visual impairments caused by diabetes. If an employee has neuropathy, they might need permission to sit on a chair or stool.
Some individuals use continuous glucose monitors but will still need an opportunity to check blood glucose with a meter. Employers should be aware that diabetes management technology is evolving, and employees may use various devices to monitor and manage their condition. These devices should be permitted in the workplace, and employees should have the flexibility to use them as needed.
Reassignment as a Last Resort
If a qualified employee with a disability can no longer perform the essential functions of their job, even with reasonable accommodations, an employer is required under the ADA to provide the accommodation of reassignment to a vacant position. The employee must be qualified for the new position, and the employer is not required to create a new position, promote the employee, or displace other employees to accommodate the reassignment.
Reassignment is often referred to as "the accommodation of last resort." This option should only be considered when all other reasonable accommodations have been exhausted and the employee truly cannot perform their current job duties even with modifications.
Legal Framework and Employer Obligations
The Interactive Process
When an employee requests accommodations for diabetes, employers should engage in what's known as the interactive process. Employers may ask an employee requesting an accommodation what the employee needs to help perform the job. Employees often request accommodations that are less burdensome or expensive than the employer anticipated.
The important thing is for the employer and employee to discuss individual needs. This collaborative approach helps ensure that accommodations are effective and appropriate for the specific situation. It also demonstrates good faith on the part of the employer and can help prevent misunderstandings or legal issues.
When Employers Can Request Medical Information
The ADA strictly limits the circumstances in which an employer can ask about an employee's medical condition or require an employee to submit to a medical exam. Employees are not required to disclose that they have or had diabetes unless they need a reasonable accommodation for the application process (for example, a break to eat a snack or monitor their glucose levels).
The circumstances in which an employer can ask about suspected diabetes include: (A) where the employer has reason to believe that there is a medical explanation for changes in an employee's job performance; (B) where the employer believes that an employee poses a direct threat to safety of themselves or others because of the medical condition; (C) where an employee has asked the employer directly for a reasonable job accommodation; or (D) where the employee is participating in a voluntary wellness program focused on early detection, screening and management of diseases like diabetes.
Confidentiality Requirements
An employer must keep confidential any medical information that it learns about an employee, except in specified situations. An employer may disclose the information to supervisors and managers in order to provide a reasonable accommodation, to first aid and safety personnel for emergency treatment, or where needed for workers' compensation or insurance purposes.
Although the employee's co-workers and others in the workplace who witness a reaction naturally may be concerned, an employer may not reveal that the employee has diabetes. Even where other employees are asking why the employee with diabetes receives special treatment (e.g., more breaks), the medical condition cannot be disclosed. Instead, employers should emphasize that they try to assist all employees with difficulties in the workplace and that such information is private.
Reasonable Accommodation Standards
An employer is required to offer a reasonable accommodation to an employee with diabetes, as long as the accommodation does not pose an undue hardship on the employer. Most accommodations for employees with diabetes are usually simple accommodations, can be provided without any cost to the employer, and should cause little or no disruption in the workplace.
Most reasonable accommodations pose little expense to employers and cause little disruption in the workplace. If granting an accommodation poses an undue hardship to the employer, they may not be required to make the change. This would include accommodations that are extremely expensive or disruptive to implement. Even then, the employer needs to try to come up with a workable compromise.
Protection from Discrimination
An employer can't refuse to hire someone based solely on their diabetes. An employer cannot refuse to hire someone just because they have diabetes. However, individuals do need to be able to perform the "essential functions" of the job they are applying for with or without a reasonable accommodation.
Once hired, employees with diabetes are protected from various forms of discrimination. They cannot be demoted, terminated, paid less, or treated differently solely because of their diabetes, as long as they can perform the essential functions of their job with or without reasonable accommodations.
Safety Considerations and Risk Assessment
Individual Assessment Requirements
When questions about safety are legitimately raised, a person with diabetes should be individually assessed to determine whether or not that person can safely and effectively perform the particular duties of the job in question. It was once common practice to restrict individuals with diabetes from certain jobs or classes of employment solely because of the diagnosis of diabetes or the use of insulin, without regard to an individual's abilities or circumstances. Such "blanket bans" are medically inappropriate.
The first step in evaluating safety concerns is to determine whether the concerns are reasonable in light of the job duties the individual must perform. For most types of employment (such as jobs in an office, retail, or food service environment) there is no reason to believe that the individual's diabetes will put employees or the public at risk.
High-Risk Occupations
In other types of employment (such as jobs where the individual must carry a firearm or operate dangerous machinery) the safety concern is whether the employee will become suddenly disoriented or incapacitated. Risk assessments should be individualized for each employee and their position. Does their position include tasks that are dangerous if they experience a low blood sugar? Certain work conditions such as driving or working alone need to be taken into consideration so they can be performed safely as well.
Even in these situations, workplace accommodations can be made that are minimal yet effective in helping the individual to manage his or her diabetes on the job and avoid severe hypoglycemia. The focus should be on what accommodations can enable the employee to perform the job safely, rather than automatically excluding them from consideration.
Occupations with Higher Diabetes Prevalence
Research has identified certain occupations where diabetes prevalence is higher than average. The three broad occupation groups with the highest adjusted prevalence of diabetes were protective services (8.9%), farming, fishing, and forestry (8.8%), and community and social services (8.4%). Industries such as protective services and healthcare support have higher risk factors for diabetes, including obesity and insufficient sleep. The top occupation groups identified as having high prevalences of diagnosed diabetes included protective services, the farming, fishing, and forestry industry, healthcare support and transportation and material moving.
Employers in these industries should be particularly aware of the need for diabetes accommodations and may want to implement proactive wellness programs to support employees with diabetes or at risk of developing the condition.
Emergency Preparedness and Response
Training Staff on Diabetes Emergencies
Employers should educate coworkers on emergency situation procedures and identification of symptoms of hypoglycemia or hyperglycemia. Training all employees on diabetes management, including recognizing symptoms of high and low blood sugar, can help create a safer and more supportive environment. This training is especially crucial because low blood sugar incidents can lead to confusion and disorientation, requiring immediate intervention.
Emergency training should cover recognizing the signs of both hypoglycemia and hyperglycemia, knowing how to respond, understanding when to call for emergency medical assistance, and knowing where emergency supplies are located. This training protects not only the employee with diabetes but also provides peace of mind for all staff members.
Developing Emergency Protocols
Employers should work with employees who have diabetes to develop clear emergency protocols. These protocols should outline what steps to take if an employee experiences a severe hypoglycemic or hyperglycemic episode, who should be contacted, where emergency supplies are kept, and when to call 911.
The protocol should be documented and shared with appropriate personnel while maintaining the employee's confidentiality. Supervisors and designated first aid responders should be familiar with the protocol and know how to implement it quickly if needed.
Creating a Diabetes-Friendly Workplace Culture
Education and Awareness Programs
Educating employees about diabetes can help create a more supportive and inclusive workplace. Offering training sessions or workshops on diabetes management can increase awareness and understanding among coworkers and supervisors, leading to a more accommodating work environment.
Employers may be able to avoid many questions by training all employees on the requirements of equal employment opportunity laws, including the ADA. Additionally, an employer will benefit from providing information about reasonable accommodations to all of its employees. This can be done in a number of ways, such as through written reasonable accommodation procedures, employee handbooks, staff meetings, and periodic training.
Addressing Stigma and Discrimination
Unfortunately, stigma and discrimination remain significant issues for employees with diabetes. Two-fifths [40%] of employees living with diabetes reported negative treatment in the workplace because of their condition, according to a new global study. Nearly half [46%] of employees diagnosed with type 1 diabetes reported negative treatment in the workplace, compared with just over a third [36%] of workers living with type 2 diabetes.
The consequences of this stigma are serious. A third [32%] of employees living with diabetes have considered leaving their job due to the way people with the condition are treated at work. One in ten employees living with diabetes has not disclosed their condition to their employer, with 43% of those saying they feared being treated differently. Nearly a third [29%] of these respondents were concerned that disclosure could limit their career progression.
Clear policies that protect against health-based discrimination help foster a culture of respect and inclusion. Using person-first language (e.g., "people with diabetes" instead of "diabetics") further reinforces empathy and awareness. With nearly 80 percent of people with diabetes reporting stigma, strong anti-discrimination measures can empower individuals to disclose their condition without fear of mistreatment.
Promoting Open Communication
The International Diabetes Federation urges employers to foster supportive environments where health conversations are safe and to implement clear policies that address the needs of employees with diabetes. Creating a culture where employees feel comfortable discussing their health needs without fear of judgment or discrimination is essential.
Employers can promote open communication by clearly communicating their accommodation policies, training managers on how to respond to accommodation requests, ensuring confidentiality, and demonstrating through actions that employees with diabetes are valued members of the team.
The Business Case for Supporting Employees with Diabetes
Productivity Benefits
Small adjustments to the work environment or schedule can reduce absenteeism and presenteeism (when an employee goes to work despite a medical illness that prevents full functioning), increase productivity, concentration, and energy levels, and reduce the chance of on-the-job injury.
With more than 29 million Americans living with diabetes, paying attention to the disease makes good business sense. Working with diabetic employees can improve productivity, decrease absenteeism and promote healthy lifestyles. When employees can effectively manage their diabetes at work, they're more likely to maintain stable blood sugar levels, which directly impacts their energy, focus, and overall performance.
Cost Savings
Helping employees prevent type 2 diabetes and manage their diabetes can help them be healthier and more productive. It can also lower health care costs for them and for the business. Enhancing benefits to include diabetes management programs delivers strong ROI—reducing medical costs, boosting productivity, and lowering absenteeism.
The costs of not supporting employees with diabetes can be substantial. Beyond direct medical costs, employers face expenses related to absenteeism, reduced productivity, disability claims, and employee turnover. Investing in reasonable accommodations and diabetes support programs is typically far less expensive than these indirect costs.
Legal Compliance
Providing appropriate accommodations helps employers stay in compliance with the law. Failing to provide reasonable accommodations or discriminating against employees with diabetes can result in costly legal action, including EEOC complaints, lawsuits, and damage to the company's reputation.
The number of charges filed under the ADA alleging diabetes-based discrimination has jumped in recent years, according to the Equal Employment Opportunity Commission (EEOC). Proactively implementing accommodation policies and training managers on their obligations can help employers avoid these legal risks.
Employee Retention and Morale
A lack of workplace support can lower morale for those managing the disease. Conversely, when employers demonstrate genuine care for employee health and wellbeing, it builds loyalty and improves retention. Workplace wellness initiatives, like diabetes screening, not only positively impact productivity and costs but also boost employee morale, retention, and company culture. In the post-pandemic era, employees seek employers who genuinely care about their health and well-being.
A supportive, diabetes-friendly workplace benefits both employees and employers—boosting morale, reducing absenteeism, and improving health outcomes. Employees who feel supported are more engaged, productive, and likely to remain with the organization long-term.
Implementing an Effective Accommodation Program
Developing Written Policies
Employers should develop clear, written policies regarding reasonable accommodations for employees with disabilities, including diabetes. These policies should outline the process for requesting accommodations, explain how requests will be evaluated, describe the interactive process, and assure employees of confidentiality.
The policy should be easily accessible to all employees and included in employee handbooks, onboarding materials, and the company intranet. Making the policy visible demonstrates the organization's commitment to supporting employees with disabilities and makes it easier for employees to understand their rights and how to request accommodations.
Training Managers and Supervisors
Managers and supervisors play a critical role in implementing accommodations effectively. They need training on recognizing accommodation requests, engaging in the interactive process, maintaining confidentiality, and supporting employees with diabetes in their day-to-day work.
Training should cover both the legal requirements and the practical aspects of supporting employees with diabetes. Managers should understand that accommodations are not "special treatment" but rather necessary adjustments that enable employees to perform their jobs effectively.
Regular Review and Adjustment
Once accommodations are in place, it would be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed. Diabetes is a dynamic condition, and an employee's needs may change over time as their health status changes or as they adjust their treatment plan.
Employers should establish a process for periodically checking in with employees who have accommodations to ensure they're still effective. This doesn't need to be formal or frequent—a simple conversation once or twice a year can help identify any needed adjustments before problems arise.
Documentation and Record-Keeping
Employers should maintain appropriate documentation of accommodation requests and the interactive process while ensuring that medical information is kept confidential and separate from personnel files. Documentation should include the accommodation request, any medical documentation provided, notes from interactive process discussions, the accommodations granted, and any follow-up or adjustments made.
This documentation serves multiple purposes: it demonstrates good faith efforts to accommodate employees, provides a record if questions arise later, and helps ensure consistency in how accommodation requests are handled across the organization.
Wellness Programs and Prevention Initiatives
Diabetes Screening Programs
A simple A1C blood test can reveal the average blood sugar level of an employee over the past 3 months. The results of the blood test can indicate if an employee currently has untreated diabetes or if they are in prediabetic range. Employers can play a crucial role in providing preventative care for their workforce. Offering diabetic screening helps identify employees with prediabetes and ensures those with diabetes receive appropriate care and support.
Screening programs should be voluntary and confidential. Employers should partner with healthcare providers to offer convenient screening options and ensure that employees who screen positive receive appropriate follow-up and resources.
Diabetes Prevention Programs
Employers can recommend the National DPP lifestyle change program for people at risk for type 2 diabetes and diabetes self-management education and support (DSMES) services for people diagnosed with diabetes. Employers can select benefits programs that cover enrollment in these two effective interventions and make it easier for employees to participate through flexible scheduling or by offering those services on site.
The CDC recommends participation in diabetes self-management education and support (DSMES) services to prevent diabetic complications such as eye disease, kidney disease, and nerve diseases. DSMES helps people with diabetes effectively manage their blood sugar, blood pressure, and cholesterol and get preventive care.
Creating a Healthy Work Environment
Creating a healthy environment benefits all employees. Access to nutritious foods and opportunities for physical activity not only supports diabetes management but also helps prevent the disease and promote overall wellbeing for all employees.
Employers can create a healthier work environment by providing healthy food options in cafeterias and vending machines, creating spaces for physical activity, offering standing desks or walking meetings, encouraging regular breaks, and promoting work-life balance to reduce stress.
Special Considerations for Different Work Environments
Office Environments
In traditional office settings, accommodating employees with diabetes is typically straightforward. Most offices already have break rooms with refrigerators, private spaces that can be used for blood sugar testing, and flexible break schedules. The main considerations are ensuring employees have access to these resources and that managers understand and support the need for diabetes management during work hours.
Remote Work Settings
Remote work can actually make diabetes management easier in some ways, as employees have full access to their home environment and supplies. However, employers should still ensure that remote workers with diabetes have the flexibility they need for medical appointments, understand that they may need to step away from their computer periodically, and have access to the same accommodation resources as on-site employees.
Manufacturing and Industrial Settings
In manufacturing or industrial environments, accommodations may require more planning. Employers need to ensure that employees can access their supplies and take breaks even in settings with strict production schedules. This might involve designating backup personnel to cover during breaks, creating accessible storage for supplies near work areas, or adjusting break schedules to accommodate diabetes management needs.
Healthcare Settings
Healthcare workers with diabetes face unique challenges, particularly those working long shifts or in high-stress environments. In healthcare settings, developing effective diabetes interventions involves management participation and staff engagement and needs. Accommodations might include ensuring access to food and supplies during long shifts, providing adequate break times even during busy periods, and addressing the high-stress nature of healthcare work.
Transportation and Driving Positions
Employees in transportation roles require special consideration due to safety concerns. Truck drivers have a unique work environment, with most of their work time spent driving. Accommodations for drivers might include ensuring they have supplies readily accessible in their vehicle, allowing for regular stops to check blood sugar and eat, and providing education on managing diabetes during long drives.
Common Challenges and Solutions
Addressing Coworker Concerns
Proactive approaches may lead to fewer questions from employees who misperceive co-worker accommodations as "special treatment." When coworkers question why an employee with diabetes receives accommodations, managers should handle these situations carefully while maintaining confidentiality.
Employers should emphasize that they try to assist all employees with difficulties in the workplace and that such information is private. Inquiring employees should be reminded that their privacy would be equally respected. This approach addresses concerns without revealing medical information.
Managing Performance Issues
Having diabetes doesn't excuse poor performance, but employers need to consider whether performance issues might be related to inadequate accommodations or poorly controlled diabetes. If performance problems arise, employers should engage in a conversation with the employee to determine whether additional accommodations might help or whether the issues are unrelated to diabetes.
It's important to separate diabetes-related needs from performance expectations. Employees with diabetes are expected to meet the same performance standards as other employees, but they should have the accommodations necessary to do so.
Handling Disclosure Decisions
Sometimes, the decision to disclose depends on whether an individual will need a reasonable accommodation to perform the job (for example, breaks to take medication or a place to rest until blood sugar levels become normal). A person with diabetes may request an accommodation after becoming an employee even if she did not do so when applying for the job or after receiving the job offer.
Employers should create an environment where employees feel comfortable disclosing their diabetes if they choose to do so. This means having clear policies, training managers appropriately, maintaining confidentiality, and demonstrating through actions that employees with diabetes are valued and supported.
Resources and Support for Employers
Employers seeking guidance on accommodating employees with diabetes have access to numerous resources. The Equal Employment Opportunity Commission (EEOC) has published several guidance documents on ADA protection for diabetes in the context of employment. The Job Accommodation Network, a non-profit organization, has published a non-exhaustive list of accommodations that employees with diabetes can seek, among other articles that deal with diabetes and the ADA.
The American Diabetes Association provides extensive resources for both employers and employees, including information about legal rights, accommodation ideas, and diabetes management strategies. Their website at diabetes.org offers fact sheets, toolkits, and contact information for additional support.
The Job Accommodation Network (JAN), available at askjan.org, provides free, confidential guidance on workplace accommodations and disability employment issues. Their consultants can help employers identify effective accommodation solutions for specific situations.
The Centers for Disease Control and Prevention (CDC) offers resources for employers at cdc.gov/diabetes, including information about diabetes prevention programs, workplace wellness initiatives, and the business case for supporting employees with diabetes.
The EEOC's guidance document "Diabetes in the Workplace and the ADA" provides comprehensive information about legal obligations and best practices. This document is available on the EEOC website at eeoc.gov and should be required reading for HR professionals and managers.
Moving Forward: Building an Inclusive Workplace
Creating a truly inclusive workplace for employees with diabetes requires more than simply complying with legal requirements. It demands a genuine commitment to understanding the challenges these employees face and proactively creating an environment where they can thrive.
Strengthening diabetes awareness among all staff and offering flexible arrangements that facilitate diabetes management at work will help ensure that people living with the condition do not feel stigmatised. Workplaces that offer these provisions are better positioned to support all employees, regardless of their health needs.
The key elements of a diabetes-friendly workplace include clear accommodation policies that are well-communicated and consistently applied, trained managers who understand their obligations and how to support employees with diabetes, a culture of openness where employees feel comfortable discussing their health needs, confidentiality protections that are rigorously maintained, emergency preparedness with trained staff who know how to respond to diabetes-related emergencies, wellness programs that support both prevention and management of diabetes, and regular evaluation and improvement of accommodation practices.
Smart employers know there's a strong business case for helping employees with diabetes stay healthier. Beyond the legal obligations, supporting employees with diabetes is simply good business practice. It improves productivity, reduces costs, enhances employee morale and retention, demonstrates corporate social responsibility, and creates a more inclusive workplace culture that benefits everyone.
The key is to assess the ability of applicants and employees to perform a job with or without reasonable accommodation. By focusing on abilities rather than limitations, engaging in meaningful dialogue with employees about their needs, implementing accommodations flexibly and creatively, and fostering a culture of support and understanding, employers can create workplaces where employees with diabetes can succeed and contribute fully.
People with diabetes may develop some limitations, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with diabetes will need accommodations to perform their jobs and many others may only need a few accommodations. The individualized approach is essential—what works for one employee may not work for another, and needs may change over time.
As diabetes prevalence continues to rise in the working-age population, the importance of creating diabetes-friendly workplaces will only increase. Employers who take proactive steps now to support employees with diabetes will be better positioned to attract and retain talented workers, maintain productivity, control costs, and build truly inclusive organizations where all employees can reach their full potential.
The investment in workplace accommodations for employees with diabetes is minimal compared to the benefits. Most accommodations cost little or nothing to implement, yet they can make a profound difference in an employee's ability to manage their health and perform their job effectively. By embracing these accommodations as opportunities rather than burdens, employers can create workplaces that support the health, wellbeing, and success of all employees.