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Living with Diabetes

Diabetes and Work

What are the potential difficulties with regard to employment?

CartoonIt is important that you disclose your diabetes if required to do so on an employment application. There is no reason why people with diabetes should not have equal access to job opportunities. Difficulties may be encountered due to treatment with insulin or due to complications of diabetes. Treatment with insulin, even with careful monitoring, carries a risk of hypoglycaemia, which may be considered to be unacceptable to certain employers. Complications such as retinopathy with visual impairment, or angina may turn out to be an obstacle to securing the job you want. Your prospective employer may also consider the possibility of your job being hazardous to your health.

What factors will my doctor / employer take in to consideration?

Some or all of the following may be taken in to account when assessing the situation.

  • Is your diabetes stable (well controlled) ?
  • Have you had any ‘disabling’ hypos – i.e. hypoglycaemia requiring assistance from another person ?
  • Have you normal awareness of hypoglycaemia ?

Do you have any evidence of severe complications, such as advanced retinopathy, kidney disease, peripheral neuropathy or circulatory problems?

Are there any jobs which are denied to people on insulin?

Yes. Unfortunately being on insulin precludes you from taking up the following opportunities.

  • Driving HGVs, buses and taxis
  • Armed forces
  • Fire service
  • Ambulance service
  • Prison service
  • Airline pilots and Airline Cabin crew
  • Air traffic control
  • Offshore work e.g. – on oil rigs and ships

This list is by no means exhaustive. You may feel (justifiably) that some employers unfairly prevent you from taking up a post which you could safely undertake. Individual cases are best discussed further with your doctor.

Shift work and diabetes

Shift work often leads to difficulty with diabetes control, especially for people on insulin. Proper training and self-monitoring are essential.

Frequent changes in daily routine with spells of night duty present problems with working out timing and dosage of insulin injections. If shift work is to be undertaken, shifts from 0600 to 2200, ideally excluding night duty should be considered.

Why is shift work disruptive?

  • Changes to timing of meals
  • Variations in level of activity at night
  • Variations in levels of stress
  • Difficulty in injecting at work
  • Timing of periods of ‘catch-up’ sleep (interferes with meals and injections)

Should I change jobs?

Ideally, not. Many employers will now accommodate you within the same organisation even if it means a change of role.

What is the ideal job?

  • Fixed working hours
  • Regular physical activity rather than an overly sedentary desk-bound occupation
  • Ability to perform self monitoring and injections at work

 

Dr Nishan Wijenaike, Consultant Physician
West Suffolk Hospitals Diabetes Service.
October 2002