Bringing Your Diabetes to Work

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Kerri Sparling: Balancing DiabetesDiabetes: it goes with you to the store, shows up at Christmas, and trots along to work with you every single day.  What’s the best way to talk about your diabetes with your employers and coworkers, or should you at all?  Kerri Sparling, in her debut memoir “Balancing Diabetes” shares her experiences, and the experiences of a few d-friends.

I comb through job openings all the time because you never know when the urge to go down a new path will strike you. Being ready to apply includes a résumé polish, lint-rolling all the cat hair off my business suit (a daunting task), and preparing for the interview process.

And as a person with diabetes, preparing for an interview also includes the internal debate as to if, and when, it is best to let your employer know you have diabetes.

Safety is a top priority for me, and I’m not comfortable being involved in work or social situations without at least someone knowing I have diabetes. I want my employer to know that I have diabetes because that keeps me safest. If someone strolls by and sees me pale and almost passed out at my desk, I can’t have them think I’m recovering from a wild night of unicycling. I need for diabetes to be the first thing they think of. I would much rather issue the “I’m Kerri and I have type 1 diabetes …” educational speech than to need help and have no one aware of my health needs. The more people who know, the safer I am.

But what about an interview environment? Or even after a job is secured—when is the best time to tell? And are my rights protected in the workplace, as a person with diabetes?

Katie Hathaway, Managing Director, Legal Advocacy at the American Diabetes Association, views disclosure as a personal decision that varies from individual to individual. “Whether to disclose your diabetes to an employer or potential employer is an entirely personal decision, and not one I can make for someone else. There are pros and cons to both choices. If you disclose your diabetes, you may find coworkers who are willing to help you if your blood glucose drops low and you need someone to get you a juice, or even to administer glucagon. Disclosing your diabetes is also necessary if you need an accommodation to do your job—for example, you sometimes experience hypoglycemia in the morning and need to arrive late to work. If your employer does not know that your late arrival is because of a disability, or you have not worked that out with your supervisor in advance, you could be at risk for discipline or even discharge. On the other hand, some people who either don’t need accommodations or who do not want to risk discrimination if they disclose may choose to keep this information private. There is no wrong choice here.”

Personally, I don’t want anyone knowing I have diabetes until the deal is closed. When the interviewer looks at me, I want them to see a potential employee who is ready to give her all at the workplace, not a person whom they perceive as someone who will take extra sick days and will not be able to perform. People with diabetes are protected by the Americans with Disabilities Act and employers are not to discriminate against someone for having diabetes. I appreciate that legislation. However, I use extra caution.

Flashback to 2004: I test my blood sugar in the car before I go into a job interview. My meter reads 104 mg/dL. Below 150 mg/dL, for me, is too low for an interview, as I know that the more nervous I become, the faster my blood sugar may drop. I pop two glucose tabs into my mouth to take a preemptive strike against ill-timed hypoglycemia. I also switch the pump from “audible beep” to “vibrate” alarm mode and tuck it deep into my suit jacket pocket. No one knows I’m wearing a medical device. My medical alert bracelet is jangling on one arm, but it is discreet. My purse has my testing kit and a tube of glucose tabs for a just-in-case low. Upon meeting me, I look like a woman in pursuit of a job, without a whisper of evidence of diabetes.

The interview proceeds on its merry path, same as any other. They don’t ask, because they can’t, and I don’t tell because diabetes doesn’t affect my performance at work. Smiles were exchanged, an offer was made, and I’m hired.

It’s not until my first or second day at work that I pull my new boss aside and tell them I have diabetes. “Just so you know, so I can feel safe,” I offer. They always respond with, “I’m glad you told me.”

Sara Nicastro, who not only has type 1 diabetes but also a Masters of Education in College Student Affairs and has worked as a career counselor and academic advisor at a college, brings a perspective from both sides of the table. “Disclosing diabetes or any disability is definitely a frequently asked question in the job search and career planning process. Employers are not allowed to discriminate against a candidate who has diabetes just like they are not allowed to discriminate based on gender, ethnicity, age, marital status, or any other protected class. As long as diabetes does not affect the candidate’s ability to do the essential functions of the job, the employer does not have any right to know and a person with diabetes can choose to keep their diabetes private throughout the interview process and after being hired. On the other hand, if you can’t be honest about yourself in an employment situation, and have to hide part of who you are, is that the right employment situation for you?”

When it comes to disclosure, your diabetes preferences may vary (just as everything with diabetes seems to vary). Katie views disclosure in the workplace as a very personal decision, and one that is highly influenced by both the job itself and the openness of coworkers to understand diabetes. “Some people who work in safety-sensitive jobs may be reluctant to go too far into the weeds of diabetes management for fear that a coworker will think they are unsafe to the job, and although decisions about whether a person’s diabetes poses too big of a risk are not made by coworkers, it may be an annoyance one would rather not deal with. There is also the potential problem of over-policing by well-meaning coworkers. It’s very much a balance between what you need them to know and what you feel comfortable with them knowing about you.”

Or perhaps what you feel comfortable with them assuming about you. Sara told me about an experience she had, where diabetes was mistaken as the root of an impassioned argument.

 “At a different job, I was explaining to coworkers some of the common symptoms of both severe high and low blood sugars, and that when my blood sugar is low I often become irritable,” Sara said. “A few months later, I was discussing a situation with my director. We disagreed on the best approach to resolve the issues and I was passionately arguing my case. Apparently I was a little too passionate, because she said to me something like ‘I think you need to go test your blood sugar. You are getting pretty upset about this.’ I knew that my blood sugar was in range so it made me even angrier that she was blaming my passion on diabetes. I stormed back to my office and got out my meter. I still remember the result— 93 mg/dL. I stomped back to her office with the meter in my hand. As I held the meter up to her face, I said, ‘See. I’m not low. I’m just angry!’ 

“While employers are not allowed to discriminate based on diabetes, you still want to be careful about  the timing when you disclose it,” said Sara, calling back her experience as a career counselor. “The interview process should be a conversation. The candidate is finding out more information about the company at the same time that the company is finding out more information about the candidate. As long as your diabetes does not affect your physical ability to do your job, my advice on disclosure is to wait until after the offer of employment has been extended. That is the time in which you are finding out more about the insurance plans and other benefits of the company, so it makes sense to find out how your diabetes will fit with the organization. Depending on the size of the company, you are most likely dealing with human resources at this point as they process your paperwork, and not actually the people responsible for any hiring decisions. Think of it the same way as salary negotiation. You don’t try to negotiate your salary in your first interview when they don’t know anything about who you are and what you can do. It’s better to wait until the company is convinced of your worth and will do anything to have you before you try to negotiate the benefits of your position. Once you have convinced them of your ability to do the job, your diabetes won’t seem like anything more than a minor discussion point.”

I’ve never had trouble with the “when” of telling, but that balance between “telling” and “over-telling” is one I’ve struggled with throughout the years. I never want to make my diabetes seem like a reason why I wouldn’t perform well at work, but at the same time, I wanted my employers and coworkers to understand that diabetes might require a little extra understanding at times. And sometimes, I may actually need someone’s help.

A few years ago, I worked in the insurance industry in Rhode Island, as part of a large company in an office that housed approximately one hundred employees. My cubicle was near the front of the building, and the lunchroom was located at the far end of the building. I don’t recall the specifics of what happened, but afterward, my coworker told me that I had gotten up from my desk, abruptly, and started walking toward the lunchroom. “Only you weren’t really walking, but more like staggering, touching your hand against the walls as you moved between the cubicles, like you were trying to hold yourself up. We got up to follow you, and when we caught up to you, it was clear that your blood sugar was in trouble.” Two of my coworkers helped get me to the lunchroom and bought a can of cranberry juice from the vending machine, urging me to drink it and sitting with me until I had consumed the contents of the can.

“For a few minutes, you weren’t even looking at us. You were looking through us. But then, it was like the juice hit your system, and all of a sudden, you were back. And then you were fine. It was crazy, watching you tune back in like that. I can’t even imagine where your brain was for those few minutes.”

Even though I was embarrassed by the low, I was grateful for the quick and learned response of my coworkers. Because I had taken the time to explain low blood sugars and how to treat them, they were able to help me when I needed it. And that kind of safety net is worth a few minutes in a team meeting, explaining diabetes to them.

“I start out with the simple stuff when I explain diabetes to coworkers. I want them to know how to help in an emergency situation without being distracted by all the other details of living with diabetes,” said Sara. “I explain that emergency situations will usually occur when my blood sugar is too high or too low, but that an emergency when my blood sugar is too low is significantly more likely. I show them where my fast-acting sugar is and tell them to give that to me if I need help. The way I figure it, if my blood sugar is dangerously low, a little bit of sugar can save my life. If my blood sugar is dangerously high, that little bit of sugar is not going to make much of a difference. I would rather err on the side of a low blood sugar to be able to get the help that I need.”

To that same end, I made a “diabetes emergency kit” for when I worked in an office. In it were some diabetes-related supplies, such as backup infusion sets for my insulin pump and an insulin pen with fast-acting insulin, in case my pump was to fail at work. It also included a jar of glucose tabs and an emergency glucagon kit. I always instructed at least two people in my office to administer glucagon, if needed. (And I always picked people I worked closely alongside. Actually, in one case, I picked the guy whose wife had type 1 diabetes, because he already knew all the necessary details.) And on the lid of the box, I wrote my “in case of emergency” phone numbers, including those of my mother and my husband, in the event that a family member needed to be alerted to a situation. It was kind of creepy, making that kit and taking into account all of the what-ifs that can happen throughout the day, but once it was completed and safely stashed at work, I felt prepared for the worst while I continued to assume the best.

Balancing Diabetes is available on Amazon.

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Khürt L. Williams
Khürt L. Williams

“In it were some diabetes-related supplies, such as backup infusion sets for my insulin pump and an insulin pen with fast-acting insulin, in case my pump was to fail at work.”

Your insurance paid for,you to have vials as well as insulin lens? Did you tools the insulin pens at the end of the month (given that out of the fridge they are not to be used pass 28 days)?

This seems wasteful and costly ( for the insurance company ). 

Khürt L. Williams
Khürt L. Williams

“In it were some diabetes-related supplies, such as backup infusion sets for my insulin pump and an insulin pen with fast-acting insulin, in case my pump was to fail at work.”

Your insurance paid for,you to have vials as well as insulin lens? Did you tools the insulin pens at the end of the month (given that out of the fridge they are not to be used pass 28 days)?

This seems wasteful and costly ( for the insurance company ). 

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