Does working in transport increase your diabetes risk?
We asked Kate Walker from the Diabetes Safety Organisation to share with us the reasons why our work together on diabetes is so important to TSSA members and transport workers. This is the first in a series of blog posts on diabetes awareness, and will help start our community discussion with TSSA reps and impacted members on Friday 14th June, 1230-1330. If you are interested in attending that virtual event, please register using the link button at the end of this blog.
Kate Walker, Diabetes Safety Organisation...
Type 2 diabetes is a national health emergency in the UK. For every 1,000 employees, 82 have diabetes, 20 of these do not know they have the condition – the majority of people have no symptoms when they are diagnosed. Given how much time we spend at work, workplaces are a significant factor in our personal risk of developing type 2 diabetes and our ability to manage diabetes if we have the condition.
Diabetes is a complex and frequently misunderstood condition. Often played down as “less serious” than other conditions, diabetes is the leading cause of blindness in the working-age population and causes 190 limb amputations a week (outcomes referred to as ‘diabetes complications’). Around 500 people die prematurely each week in the UK from diabetes as the primary cause. People with diabetes have a higher risk of 57 other health conditions (‘co-morbidities’) including heart disease, stroke, cancer and kidney disease. People with diabetes are 10 times more likely to experience fatigue, for example, but may not associate their fatigue with diabetes.
The day-to-day management of diabetes also brings its own risks. Around 600,000 people with type 2 diabetes and 400,000 people with type 1 diabetes use insulin to manage their diabetes. How the body responds to insulin can change – for example, a hot day can increase the body’s sensitivity to insulin – and this can make it challenging for people with diabetes to predict the exact dose needed. Too small a dose and blood sugar levels remain too high, increasing the risk of complications and comorbidities if high over long periods. Too large a dose and the person risks a ‘hypo’ – when blood sugar drops too low.
Hypos and hypers can impair balance, coordination, and concentration. Severe hypos can cause seizures and loss of consciousness. For every 1,000 employees there will be an estimated 1-3 severe hypos happening in the workplace per month. In our research, half of employees said they would not know what to do if someone was having a hypo.
The link between work and diabetes risks
Most people know that type 2 diabetes is linked to poor diet and lack of exercise, but many are unaware that workplace factors such as stress, ability to take breaks, shift patterns and time to rest between shifts all increase diabetes risk. One in three working-age people are ‘pre-diabetic’ and work practices and culture significantly contribute to that risk (take the Diabetes UK ‘know your risk’ test here https://riskscore.diabetes.org.uk/start). People who drive for a living are estimated to be twice as likely to develop diabetes than the average population.
Not only can your workplace increase your risk of developing diabetes, if you have the condition, your workplace might create barriers to managing the condition effectively. Around 75% of employees with diabetes said they frequently went against their doctor’s recommendations by ‘running their bloods high’ at work – i.e. they reduced their medication dosage to avoid the risk of a hypo. However, the trade-off to doing this is the increased risk of long-term complications and co-morbidities.
The understanding and attitudes of line managers plays a major part in how well employees with diabetes can manage their condition effectively at work. Only 48% of people with diabetes attend their regular diabetes checks, with lack of ability to take time off work frequently cited as a contributing factor. During the Covid-19 pandemic, the number of people attending their routine check-up halved and resulted in an extra 3,075 deaths among people with diabetes during a 15 week period – an increase in the diabetes death rate of 11%. 63% of employees with diabetes describe their line manager as unhelpful or unsupportive of their diabetes.
Managers who do – knowingly or unknowingly – compromise the heath and work of employees with diabetes are in contravention of the Equality Act. Diabetes meets the definition of disability in this Act which means employees with diabetes cannot be discriminated against and employers must make reasonable adjustments to support their ability to work effectively.
Diabetes and safety
Hypos can create significant safety risks: for the person having the hypo and, for those in the transport sector, their colleagues and passengers. Hypos are common for people with diabetes yet they are often hidden from view – either because a person feels embarrassed by experiencing a hypo or because they are recorded in health and safety reporting as something else. Not managing diabetes effectively can make you 30% more likely to have an accident than drivers without diabetes.
Having hypokits (similar to first aid kits) available and training key members in the workforce on their use can help mitigate that risk and may help employees with diabetes – and passengers – feel safer. Undiagnosed diabetes can also present safety risks: it can lead to loss of sensation in feet which is a particular risk for drivers. It is really important for workplaces to increase awareness of diabetes and encourage testing so that people can get help as soon as possible.
Diabetes and early workforce exit
Employees with poorly managed diabetes are also more likely to exit the workforce prematurely. An estimated 38% employees with diabetes aged 45-64 exit the workforce early due to diabetes complications. In a workforce of 1,000 people, this could be equivalent to losing 14 highly skilled workers in the 45-64 age group each year to diabetes complications.
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Keep an eye out for the next blog on diabetes in the workplace and register for our event on Friday 14th June to mark Diabetes Awareness Week.
