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‘changing the conversation’ around diabetes stigma in the workplace
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this article was produced by the healthing editorial team with the support of a grant from diabetes canada. while diabetes canada made the production of this article possible, they did not have any editorial influence or control over the content, including review prior to publication.
when lenaee dupuis started her professional career, she aspired to be a doctor or a nurse. but having type 1 diabetes since she was two years old, she was told that it wasn’t likely her condition would allow her to handle the shift work involved.
“it was very valid at the time,” she said. “that was 30-plus years ago.”
while medical advancements have made it easier for people living with diabetes to go for the jobs they want, stigma around diabetes and its varied effects are still strong in the workplace.
“there’s this common perception that diabetes is a lifestyle condition. it’s something that if you ate better or if you exercise or these myths and misconceptions that you wouldn’t get diabetes,” said shusmita rashid, executive director of the change the conversation initiative with diabetes canada. “i think that shows up in terms of why people are less likely to disclose that they have diabetes, that stigma.”
at work, if people are open about their diabetes diagnosis, they may have to deal with comments from coworkers and other staff about a lot of what they’re doing in the workplace. the comments can range from asking about why they’re eating a certain thing if they have diabetes to people being irritated that they take too many breaks to keep their condition under control.
some people face the fear that a diabetes diagnosis will have a negative “impact on their career opportunities and career progression,” like failing to get a promotion.
“people might think, ‘can they take on a high-stress, high-pressure position that might require travel?’” said rashid. “those types of questions come up to the point where people have decided not to disclose.”
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dupuis felt her career goals stifled 30 years ago, and again when she worked in the corporate world. she noticed that the job itself still wasn’t conducive to giving her the time needed to manage her diabetes and excel in her job.
“quite often, people will maybe not aspire. that is one of the reasons that i moved from a corporate job into being self-employed because if i have a low in the middle of the night, i can maybe sleep in and manage my day a little bit easier,” she said.
unless you’re living with diabetes or know someone who does, it’s hard to imagine what really goes into managing the disease.
“there’s often a sense of apathy that a lot of people have diabetes, and it’s a very common condition, and people can just deal with it. one thing we know about diabetes, it’s a relentless condition … managing diabetes is a full-time job in a way,” rashid said. “people are not necessarily aware of that unless they have a member of their family or a friend with diabetes.”
people also believe that those living with diabetes are less able to accomplish certain feats in the workplace, such as taking on additional work or being able to “perform at their fullest extent and we know that’s not true,” rashid added.
wellness programs and work accommodations for diabetes often fall short
health and wellness have become such a significant focus in many people’s lives that many companies have wellness programs baked into the perks of employment. these wellness initiatives are intended to provide people with the time and resources to practice self-care in ways that foster optimal mental and physical health.
but for people living with diabetes, these programs often fail to recognize what’s required for people to be successful at work while still staying on top of their diabetes care.
“wellness initiatives are based on the company,” said dupuis. at their discretion, they may offer diabetes education or diabetes day activities, but not all are on the ball when it comes to specific conditions.
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employers in canada are also legally obligated to provide workplace accommodations for employees living with diabetes. but even though it’s the law, it doesn’t mean that these accommodations are where they’re supposed to be—especially because stigma is so rampant.
having to provide accommodation is all well and good, but it only really works when the people who need support are comfortable enough to ask for it.
“we know from the research that 40 per cent of people living with type 1 diabetes and nearly 60 per cent of people living with type 2 diabetes never or rarely ask for support to help manage their diabetes when they need it,” said rashid.
“because of that internal blame, shame, lack of support externally, they’re missing appointments, they’re not managing the self-management pieces that they could be at work because there’s fear of repercussion or the prejudice that they might be feeling from their fellow employees or manager, supervisors.”
not having support or a plan in place that makes it easier for people with diabetes to come to work and manage their condition can also lead to poor and unnecessary outcomes when it comes to what happens if someone needs help.
“i recall many, many years ago; this was probably my first job. there was a man in the office who was diabetic, and his sugars were a bit more volatile than mine, and he had a low sugar, and instead of giving him some juice, some coke, whatever, they called an ambulance on him,” said dupuis. “there are … detrimental things that can happen from that; your licence can be automatically taken away and things of that nature.”
so, when the lack of understanding and support is there, people living with diabetes do not get the care or support they need and can even end up in a worse position than when they came to work that morning.
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changing the conversation
diabetes canada and advocates for people living with diabetes, like dupuis, are working to “change the conversation” so that not only do employers and employees know more about diabetes, but they’re also ready to provide what’s necessary for people living with the condition to show up and feel safe doing so.
education is vital, and everyone should know as much as possible about what diabetes is, what it isn’t and what goes a long way in supporting someone to manage it while they’re in the workplace.
“it’s really, how do we change the conversation so that we are reducing the stigma that we know people living with diabetes often feel and face? and how do we replace that stigma with empathy and support?” said rashid.
they’re working with employers, asking tough questions and finding out more about what they lack and how to fix the issues in a way that works for everyone involved.
“oftentimes, they’ll say, ‘we have a belonging that we’re targeting, and we have mental health and well-being that we’re targeting.’ and we’ve asked them, ‘what would it look like to include diabetes as one of those categories?’” said rashid.
“because chances are you do have a high-prevalence population of employees within your workplace who have diabetes, but they might not be accessing the necessary supports because it’s not acknowledged as part of the well-being initiatives.”
the changes can be simple for employers as well. but it all starts with education. employers must get to know their employees with diabetes, or other people with the condition, and actively work towards identifying the best accommodations and the most seamless way to implement them.
for example, having a small room where people living with diabetes can recover from a high or low sugar episode or privacy to take their insulin is a small fix that can go a long way. it can also be as simple as stocking a work fridge with juice or pop that people can grab and take to their workspace when blood sugars are too low.
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these changes aren’t challenging or expensive, but without knowledge of how big an impact they can have, they’re impossible to implement.
it all depends on the employee, and the only way to secure a good set of diabetes accommodations is to have conversations with these employees and pay attention before something bad happens.
“stigmas happen because of the one incident, not the 500 positive ones,” said dupuis. “so, if there’s an incident where a person goes low and there’s something not safe, do a root cause analysis. what happened before this that maybe caused the low? can we shift that?”
at its core, furthering education and fostering a stigma-free workplace is good for all parties involved. employers will be able to attract top talent who also happen to have diabetes by giving them a place where they feel safe and seen. this, in and of itself, “relates to better employer productivity and organizational performance” because not only are they hiring top talent, but they’re also able to retain them.
“four million canadians living with diabetes, that’s not a small number. there are a lot of people showing up in the workforce who have diabetes, whether it’s disclosed or not,” said rashid.
“by not thinking about it, you’re inadvertently turning away potentially top talent, and you’re not considering this idea of, especially in the age we’re in, in the age of ai, when there’s so much change in how people are showing up to work.”
she continued, “if employers can show and demonstrate that they are really behind supporting people with different conditions and creating a really inclusive environment, they are going to be able to keep innovation alive in terms of that genuine human collaboration.”
when it comes to people living with diabetes who fear disclosing their diabetes to employers, it’s also important to fight back against that stigma that they may experience while the narrative catches up to reality. because when you can ask for help, you win and you help your employer win, too.
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“don’t be afraid to say what you need,” said dupuis. [related_links /]
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