What is it?
Diabetes – where the sugar levels in the blood become too high. This is because there is not enough insulin for it to move into the cells where it gets used for energy.
According to NICE statistics approx. 32 million people in the UK have been diagnosed with diabetes. Of these 90% have Type 2.
There are 3 common types of diabetes:
- Type 1 – no insulin is produced by the pancreas
- Type 2 – not enough insulin is produced by the pancreas or the cells of the body do not react to the insulin
- Gestational – occurs in some pregnant women, particularly in the second half of their pregnancy and mostly resolves after giving birth.
Diabetes can occur at any time of life and some of the signs a person may have this include: tiredness, exceedingly thirsty, urinating much more frequently than normal, a sweetish smell to breath and unexpected weight loss.
This condition is diagnosed by blood tests but some signs can be picked up by a dipstick urine test. Some diabetics need to test their blood sugar levels regularly and a normal range is 4-9 pallour, irritability and headache. Signs that a person’s blood sugar levels are too high can be: increased urination and thirst, fatigue or drowsiness, dry mouth, decreased appetite or nausea. If the blood sugar levels are not addressed then the person may become unconscious
There are 3 levels of treatment for diabetes:
- Diet controlled only
- Diet and medication (tablet form)
- Diet and insulin (some people also take medication as well)
When a person is initially diagnosed as diabetic, particularly when starting on insulin, it can take a couple of months for their blood sugar levels to become effectively controlled. Particularly those taking insulin can need to test their blood sugar levels 4-6 times/day depending on their insulin regime and adjust the dosage accordingly.
Diabetic control can change over time and therefore most diabetics will have a review with their GP every 6-12 months to monitor this.
Potential Impact on work
Research has shown that diabetes affects the immune system and therefore they are more prone to developing infections. This may cause some increase in short term sickness absence but there are some measures that they can take to reduce this including having a healthy diet, washing their hands more frequently, avoiding others who have coughs and colds and wiping down their phone, desk or equipment with antibacterial wipes.
Office – no significant impacts identified.
Shift working – if blood sugars are well controlled a diabetic person is able to work a full range of shifts but if night working then they should have a night workers health assessment to monitor their health. A diabetic may become unfit for night working if their blood sugars are not able to be controlled.
Heights and Lone working – if well controlled then lone working and working at heights should not be an issue.
Driving – organisations should follow the guidance provided by the DVLA.
Diabetes and Equality Act 2010
“A person is classed as having a disability if physical or mental impairment has a substantial, long-term effect on their abilities to carry out normal day to day activities. Whether a condition can be classed as disabling is decided on the effects on the person of not taking medication or not following a required diet. So people with diabetes are covered by the Equality Act 2010 as they have to take their medication at appropriate times and may have to eat at set times to control their blood sugars.” Independent Diabetes Trust – “Diabetes – know your rights”
Some Reasonable Adjustments to consider
- Set meal breaks
- May need a break to check their blood sugar levels
- Able to have a snack with them whilst working
- May require time off to attend medical appointments, but this should not be needed on a regular basis
- If an individual is prone to having episodes where they have either significantly high or low blood sugars and may need first aid it could be beneficial if they advise a couple of colleagues about how to support them
First Aid for Diabetics
St John’s recommends:
For high blood sugar (hyperglycaemia)
- Call 999 straight away for medical help and say that you suspect hyperglycaemia.
- While you wait for help to arrive, keep checking their breathing, pulse and level of response. If they lose responsiveness at any point, open their airway, check their breathing and prepare to treat someone who’s become unresponsive.
For low blood sugar (hypoglycaemia)
- Help them sit down. If they have their own glucose gel, help them take it. If not, you need to give them something sugary like fruit juice, a fizzy drink, two teaspoons of sugar, or sugary sweets.
- If they improve quickly, give them more sugary food or drink and let them rest. If they have their glucose testing kit with them, help them use it to check their glucose level. Stay with them until they feel completely better.
- If they do not improve quickly, look for any other causes and then call 999 for medical help. While waiting, keep checking their responsiveness, breathing and pulse.
What you need to do ‒ if you’re unsure whether their blood sugar is high or low
- If you’re not sure whether someone has high or low blood sugar, give them something sugary anyway, as this will quickly relieve low blood sugar and is unlikely to do harm in cases of high blood sugar
- If they don’t improve quickly, call 999.
Diabetes UK – www.diabetes.org.uk
Diabetes and Driving – https://www.gov.uk/diabetes-driving
National Institute for Health & Care Excellence – https://www.nice.org.uk/guidance/ng28/chapter/introduction
U.S. National Institutes of Health’s National Library of Medicine http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354930/
InDependent Diabetes Trust – your Diabetes Know Your Rights – http://www.iddt.org/wp-content/uploads/2011/10/Your-Diabetes-Know-Your-Rights.pdf