Workplace Checkup: Keeping Patients With Diabetes Employed and Safe on the Job.

Fred is job hunting. Since being laid off 3 years ago as a result of the recession, he has worked in a series of temporary jobs that have kept food on his table but provided no health insurance, vacation, or other benefits. Fred is just like millions of other unemployed or underemployed people who desire a fulfilling job with fair pay. The only difference? Fred has diabetes. Because of this, Fred must find out about more than just the job duties, dress code, and pay structure of potential employers. He must also seek information about whether he will be able to manage his diabetes on the job and what policies potential employers have for hiring and accommodating workers with disabilities. Fred tries to get this information second-hand because he does not yet want to reveal his diabetes and risk lessening his chances of getting a job. Fred’s situation probably sounds familiar to many of the more than 18 million Americans who have been diagnosed and live with diabetes today.1 Employment provides many benefits to people with diabetes, not the least of which is the income necessary to afford diabetes supplies. Such benefits, in turn, allow workers to manage diabetes so they can remain healthy enough to work. But employment is not always trouble free for people with diabetes. Data show that lost productivity at work, absenteeism, and even early retirement contribute indirectly to the enormous costs (not only to individuals, but also to society) of diabetes.2 Just as damaging can be discrimination on the job because of diabetes. Diabetes discrimination comes in many forms and includes not only the failure to hire or promote a person because of diabetes, but also the failure to provide an employee the reasonable accommodations necessary to manage diabetes on the job, as well as termination based on fears that diabetes will make a person unsafe to perform a particular job. For workers with diabetes, it is the retail manager who will not permit the cashier to keep food or drink at her checkout station to avoid hypoglycemia, the bus driver who will not be hired because he has an A1C of 8%, the office worker who is terminated because she experienced hypoglycemia on the job, or the highly qualified individual who cannot be hired into a federal agency because of across-the-board, one-size-fits-all policies about diabetes.