With diabetes increasing rapidly among the UK population, employers must prepare for the workplace consequences. But identifying affected staff can be a challenge.
If you read nothing else, read this…
- Diabetes is rapidly increasing in the UK.
- Most sufferers have type 2 diabetes, which results from poor diet and lack of exercise.
- The symptoms of diabetes are hard to detect.
Diabetes is the biggest threat to the workforce, according to respondents to the Employee Benefits/Lorica 100 Club research 2014, published in June, and it is no surprise why.
The number of people diagnosed with diabetes has more than doubled from 1.4 million in 1996 to 2.9 million in 2013, and the figure is expected to rise to five million by 2025, according to the charity Diabetes UK. This means that an increasing number of employees will suffer with diabetes, or will become carers for sufferers.
Between 85% and 95% of diabetics suffer from type 2 diabetes, which develops when the body does not produce enough insulin, which is needed to combine with glucose to produce energy.
An unquenchable thirst and a need to urinate frequently, resulting from not being able to retain water, are the two most common symptoms of diabetes. Sufferers are also likely to be overweight or even obese, be prone to infections of, for example, the skin and urinary tract, and suffer from excessive tiredness.
Blood sugar levels
An employee struggling to control their blood sugar levels is also likely to need to eat more often or suffer from dizziness, struggle to concentrate, be prone to sweating, drowsiness and possibly slightly slurred speech and, in a worst-case scenario, they may faint.
But sufferers do not always display symptoms. Dr Marian Carey, national director of the Leicester Diabetes Centre, says: “There are many people who don’t have symptoms when they are diagnosed, which is what makes diabetes quite an insidious disease.”
And even when symptoms are present, they may not relate specifically to diabetes. Dr Tim Woodman, medical director at Bupa, says: “Type 2 diabetics is very lifestyle-related, so the symptoms, particularly in a busy workplace, would be the same for someone who has a long commute and who is generally tired and unhappy.”
Dr Mark O’Connor, managing director of Work Doctors, adds: “It’s a bit like headaches. It’s extraordinarily rare for them to be brain tumours, but they are the most common symptom of these.”
The situation is exacerbated by line managers’ general inability to identify abnormal behaviour within their team, such as employees making excessive visits to the toilet, and to then be able to relate it to diabetes. Chris Evans, senior consultant at Buck Consultants, says: “I doubt that many line managers, unless they happen to have an increased awareness for personal reasons, would pick up on those symptoms.”
Two of the most powerful remedies to prevent and manage diabetes are exercise and a healthy diet, and there is plenty of low-cost workplace support that employers can consider offering their staff.
A workplace design that facilitates movement is a good start. This may involve employers making it more difficult for staff to access the lifts than the stairs, offering flexible working to enable staff to attend the gym, and providing cycle racks for employees who commute to work by bike.
Providing workplace sports and social clubs, such as walking and yoga groups, or encouraging staff to set up their own groups, can also encourage employees to take adequate exercise.
Providing healthy snacks around the office, such as in vending machines and staff restaurants, can also help staff lead healthier lives.
O’Connor recalls helping one employer to improve its approach to workplace nutrition. The organisation’s payroll team had historically been allowed to expense a takeaway meal on the day they worked late to process employees’ pay each month, but after O’Connor’s intervention, the team was given an allowance to buy food with which they could prepare a healthy meal.“It’s not rocket science, just a bit of common sense,” he says.
Alternatively, staff could be encouraged to substitute biscuits with fruit for workplace snacks. O’Connor adds: “It’s about employers helping employees to help themselves avoid putting on weight.”
Tools, such as workplace health kiosks that can measure blood pressure and body mass index, can help employees monitor their diabetes risk levels. The Diabetes Risk Score, which is designed to predict an employee’s risk of developing type 2 diabetes within the next 10 years, could also help.
But given the possible absence of diabetes symptoms, employees may be unlikely to test their susceptibility to developing the disorder, so communication campaigns to raise workplace awareness may, at least for now, be employers’ best course of action. Campaigns must take into consideration the fact that diabetes can be hereditary.
Case study: Allianz helps staff measure diabetes risk
The checks are part of the insurer’s integrated health and wellbeing strategy, which includes a rolling education programme to raise awareness about key health issues.
Quarterly themes the organisation is focusing on this year include: resolutions to keep; improving physical activity; mental wellbeing ; and warm and hearty.
Banu Gajendran, occupational health, safety and wellbeing manager at Allianz, says: “We’ve tried to sync the topics with the government’s national targets on obesity, diabetes and cardiovascular. We’ve tried to follow suit.”
Allianz invites specialist health and wellbeing providers in to support its efforts, which, for diabetes, has included Diabetes Ireland.
The employer also has a dedicated wellbeing intranet site, which gives staff access to online tools such as risk score calculators, which they can use to detect the early warning signs of disorders such as diabetes.
“It’s about us wanting to say the right thing [to staff], but not being too intrusive and also gaining the confidence to say that we’re giving the ownership of their health and wellbeing management to them, but that we’re going to try to support them all the way along while reiterating the confidentiality of what we’re doing,” says Gajendran.
She acknowledges the difficulties of identifying staff at risk of developing diabetes, and says Allianz has a blanket approach to intervention, focusing awareness campaigns on workplace sites that are at risk of specific health issues, such as obesity and high blood pressure.
“There is no way we would be able to identify individuals, because we have a confidentiality clause that we agree with staff right from the start,” she says. “We’re not going have individual data unless someone comes up to their line manager and tells them they have just been diagnosed with diabetes and says ’this is my clinical care pathway and I need your support’.”
Viewpoint: Jennifer Maxwell: Employers are legally bound to support staff with diabetes
The Equality Act 2010 offers protection to anyone with a disability as defined under the act. People with diabetes can be covered by this definition of disability.
The Act places an obligation on employers to make reasonable adjustments to the workplace to enable staff with disabilities to continue in work and to prevent them from being placed at a substantial disadvantage.
When deciding whether an adjustment is reasonable, an employer should consider: the effectiveness of the adjustment; the practicality of making the adjustment; the costs involved; the extent of any disruption; and the extent of the employer’s financial or other resources.
Many adjustments are simple to make and cost little or nothing, and many are simply good management practice.
Reasonable adjustments may include: allowing an affected employee time off to attend diabetes-related medical appointments or diabetes education courses, which can help them manage their condition better; altering working hours so that, for example, an employee who experiences difficulties managing their condition in the morning can start later in the day; or modifying sickness absence procedures for diabetes-related absence.
It is helpful for employers to develop a good understanding of the needs of affected staff. They can do this by talking to them to make sure the correct adjustments are in place to enable them to be fully effective at work.
It is important to bear in mind that each employee will experience diabetes differently, depending on the type of diabetes they have, the medication they take and any complications they experience.
Assumptions should not be made about how an employee may be affected by their condition because this can lead to the wrong adjustments being made, or the right ones not being made at all.
Jennifer Maxwell is advocacy manager at Diabetes UK