Working with diabetes


  • People with diabetes can work almost any job.
  • As an employer, you must offer reasonable accommodation when needed.
  • The ADA prohibits discrimination against persons with diabetes.

The U.S. Centers for Disease Control and Prevention reports that nearly 10 percent of the U.S. population has diabetes. That comes to just over 30 million people. The question that may come to your mind is whether someone with diabetes can work and what rights, responsibilities, and limitations you have as an employer.

How Diabetes Works

People with diabetes work every day in all kinds of industries and jobs. You cannot tell if someone has diabetes just by looking at them, and if the diabetes is well controlled, you will never see a sign of problems.

There are two types of diabetes:

  • Type 1 Diabetes is the diagnosis received if the body does not produce insulin, a hormone important to moving glucose in and out of the cells. This condition was once known as juvenile diabetes, but it can strike adults as well.
  • Type 2 Diabetes is the diagnosis received if the body does not make enough insulin or the cells become insulin-resistant. This used to be called adult-onset diabetes. It is now known that overweight people of any age can develop it, but it is still more common in older people.

In both cases, blood glucose levels can be controlled with injected insulin or medications, and/or a healthy lifestyle. Nevertheless, there are certain jobs a diabetic may not hold. For example, the FAA in the United States does not allow a Type I diabetic to pilot a commercial airplane, no matter how well controlled the condition. Other careers and jobs may not automatically rule out candidates with diabetes, but a close analysis may be needed to determine the impact of the job on the person’s ability to control the diabetes, regardless of type.

Employer Requirements and Responsibilities

Employers need to be aware of the risks of diabetes on the job. However, according to the Americans with Disabilities Act, you may not ask job applicants about their health or require them to have a medical exam before making a conditional job offer. What is more, you cannot withdraw an offer if the applicant is able to perform the essential job functions with or without reasonable accommodation.

If you employ more than 50 full-time employees, you are required to provide health insurance that meets the standards of affordability. If you have fewer than 50 FTEs, you are not required to provide insurance, although it a benefit proven to attract high quality talent.

The SBC (Summary of Benefits and Coverage), which has to be distributed with all employee health insurance packages, provides the information required for employees to understand terms and compare options. Insurers are also required by law to include estimated coverage costs for three medical scenarios, one of which is Type 2 Diabetes. Reading the SBC for the various plan options will tell workers whether coverage is provided, adequate, and affordable.

Employing a Person with Diabetes

Although you are not allowed to ask about medical conditions or health during the application process, you may ask questions about the employee’s health after a job offer has been made. You can even require a medical exam as long as all applicants are treated equally.

If the employee happens to disclose that he or she has been diagnosed with diabetes after the job offer is made, you may ask additional questions about it. You may inquire into how long the person has lived with it, whether (and what type of) medications are taken, and if reasonable accommodations are required. You may additionally ask whether the employee requires assistance in the case of a hypoglycemic episode (abnormally low blood sugar).

You may NOT withdraw the offer as long as the person can perform the essential job functions, as mentioned above. Also, any medical information provided by the applicant is to be kept confidential.

You and the employee should perform a risk analysis to help you understand the impact of their job functions and schedule on their ability to manage their diabetes. Changing shifts, working alone, snack and meal breaks, and physical accommodations—in terms of access to a private space for administering insulin, for example—should all be part of the conversation.

A person with diabetes can perform most jobs and must not be discriminated against. Perform a risk analysis against the job requirements and provide reasonable accommodation if necessary.

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