Dr Aidin Rawshani

Working with diabetes: strategies, challenges, risks and planning

Contents

Working life with diabetes

How diabetes affects your professional life depends a lot on when you have diabetes, how well it is controlled and whether you have diabetes complications. Most people with type 1 diabetes experienced the disease during childhood or adolescence; this means that these people usually took the disease into account when choosing their profession. The impact of the disease on professional life will not be a surprise and, as a rule, you are prepared for the challenges of working life. However, if you get diabetes during your professional activity, the disease can be perceived as a major obstacle to working life. The vast majority of people who get diabetes when they are professionals have type 2 diabetes, but type 1 diabetes can also affect adults and the elderly.

In this article we discuss how diabetes affects professional life and what you can think about in order to minimize the impact of the disease on your working life. First of all, we discuss professional choices and the discussion revolves around professions that are not suitable, or less suitable, for people with diabetes. Then follow general advice and thoughts for those who work, or are going to start work, and have diabetes.

Occupations that are unsuitable or less suitable for people with diabetes

People with diabetes can work in almost any profession. Only a few professions are inappropriate if you have diabetes. As a rule, that one is unfit as a result of his diabetes is due to the following:

  1. Treatment with insulin carries a risk of blood sugar falling and this can be risky for yourself and others. This applies to both type 1 diabetes and type 2 diabetes.
  2. After many years of illness, the ability to feel blood sugar drops decreases (hypoglycemia is not felt as much). This applies to both type 1 diabetes and type 2 diabetes treated with insulin.
  3. Diabetic complications, especially visual impairment (retinopathy) is inappropriate in certain professions.
  4. Treatment with insulin requires the wearing of syringes, which may be inappropriate in some workplaces.

Thus, it is the disease itself, its complications and even the treatment that lead to the fact that one may be unfit for certain tasks and, accordingly, professions. People with diabetes, as a rule, are not suitable, or less suitable, to work with the following:

  • Some services in the field of defense.
  • Some services of the police service.
  • Some services in the field of aviation, shipping, rail traffic.
  • Some services in the field of professional vehicle traffic and transport.

It is far from all professions in these areas that are inappropriate and, moreover, the regulatory framework changes over time (treatment of type 1 diabetes and type 2 diabetes is constantly getting better and safer). To be sure whether diabetes is compatible with the professional choices you are considering, you should contact the educational site/workplace to find out if there is any obstacle to you.

Transport professions (vehicle traffic)

It is the Swedish Transport Agency who decides who is authorized to drive vehicles in traffic (e.g. car, bus, truck, taxi). At present, the following provisions apply:

  • Persons with type 1 diabetes may not have a bus or taxi driving license.
  • Persons with type 1 diabetes may not have a C certificate for heavy goods vehicles to work in professional traffic.
  • People with type 2 diabetes who have insulin therapy may drive a bus, taxi and heavy lorry requiring a C certificate if the person has the ability to feel blood sugar drops and whether the person conducts controls on his blood sugar.

Aviation

The person being treated with insulin must not work as a pilot, mate or air traffic controller. As a rule, cabin crew are allowed to work on if they are diagnosed with diabetes and need insulin. If you have diabetes treated with diet and/or tablets (type 2 diabetes) and your diabetes is well controlled, you may be able to work as a traffic controller at a special assessment.

Seaman professions

According to international regulations, all workers at sea must have a special medical certificate. This means that you must undergo a medical examination before you can serve at sea. The position of the service, the size of the ship and the length of journeys are taken into account when assessing your suitability. The longer trips, the less suitable it is to have diabetes. As a rule, those who work as a sailor who are diagnosed with diabetes can be left to work if the disease is well controlled.

Diabetes that are difficult to control, or insulin demanding, or if serious complications occur, usually means that you should not be in an unlimited service.

What is limited and unlimited speed?

Unlimited speed: Unlimited speed on the medical certificate means ocean shipping around the globe, without restrictions.

Limited speed: Limited speed on the medical certificate means Eurofart north of Brest. (Eurofart is defined in detail by coordinates in Regulation (2011:1533) on the competences of seafarers.)

Railway services

If you have diabetes, you are not allowed to work as a train driver, traffic manager or changeover staff.

The following information is available on the website of the Police:

If you have type 1 diabetes, you can’t become a cop. Police work involves many special and unpredictable situations, in many different environments, where there are high demands on decisions to be made and how to act. Police officers must therefore not have medical health conditions or illnesses that can be triggered or aggravated by work, for example due to the need to take medicines regularly. In addition, police officers must not have any disease or medical condition that could endanger the person himself, colleagues or the general public.

Defence work

The basic training of the Armed Forces is not offered to people who have diabetes. However, one can be admitted to the GU-F, which stands for Basic Soldier training for volunteers. If you apply to GU-F, an assessment of your medical fitness will be made. In addition, the Armed Forces offer civilian jobs, which you can apply for even if you have diabetes.

A professional life with diabetes

Being new in a workplace is difficult for most people. For people with diabetes, a new workplace can be an extra challenge. Worries about work chores, new colleagues and unknown environments can make you nervous. Many people with diabetes do not want others in the workplace (the manager, colleagues) to know that they have diabetes. This may be because, for example, you feel shame about your illness or because you are worried about being discriminated against. Whatever the reason, it can be stressful to keep your illness secret. There are advantages of being open and telling your employer and then even colleagues. The advantages of this are as follows:

  • By daring to talk about the disease, you normalize it. In principle, all Swedes know someone with type 1 or type 2 diabetes and the more we dare to talk about the disease, the more normalized it will be.
  • You may need help or understanding from your colleagues and employers and therefore they are good if they are informed. For example, if you become unconscious due to a fall in blood sugar, it is crucial that your colleagues know that you have diabetes.
  • You signal that you are safe in your illness.

You decide when it is appropriate to tell your employer and colleagues. However, you should consider telling your employer as early as possible. You don’t have to have a long posting, just say, for example, “It can be good for you to know that I have diabetes”. After you have told the employer, you can tell your colleagues when an appropriate opportunity is given. Your colleagues will probably have supplementary questions that you can certainly answer. You can see this as an opportunity to enlighten other people.

You are not obliged to inform your employer about your illness unless the law, existing regulations or agreements so require. When applying for a job, focus should be on your skills and the skills you can bring to the workplace. Even if you are not required to inform your boss, it is therefore advantageous to do so (see above). You should definitely inform your boss if you have diabetes complications that complicate your duties.

Try to focus on your own work and well-being, instead of what other people might think and think. Your work should be stimulating and fun and you should focus on what develops and makes you feel good at work. Being constantly worried and nervous leads to creating obstacles for oneself. Basically every Swede knows someone with type 1 or type 2 diabetes. You are perfectly normal and can enjoy professional life in a clear conscience, just like everyone else.

Fika: sugar, sugar and more sugar

High blood sugar is harmful to those who have diabetes. Most workplaces in Sweden have traditional coffee customers that usually include unnecessary sweets. If you want to eat sweets, you should do so but you should never feel socially forced to eat or drink sweet just to show that you can. This can be significant amounts of sugar because coffee and sweets are everywhere nowadays and it is often served several times daily. Therefore, be disciplined and say no to coffee that you do not really want.

When you need to be on sick leave

In Sweden, we have strong health insurance that means that you have the right to be sick leave if you are unable to perform your duties. The employer may require evidence for your sick leave, but the employer cannot question your sick leave. It is only your doctor and Försäkringskassan who assess your ability to work. The law provides you with good protection in this regard. However, it should be mentioned that the Social Insurance Agency may refuse a sick leave if their assessment does not correspond to your doctor’s. As a rule, Försäkringskassan does not question the doctor’s assessment but in some cases (especially in the case of longer sick leave), Försäkringskassan wants to make an assessment of its own and it is then valid. Do not forget that the vast majority of employers are caring and caring for their employees. Make sure you have good and open communication with your employer.

Keep in mind the following:

  • In most western countries, you have the right to report sickness from work for the first two weeks. After two weeks, a medical certificate is required, which is also sent to the Insurance Agency (the doctor usually sends the certificate electronically to the Swedish Social Insurance Agency). The certificate is free of charge.
  • It is the doctor who decides how long you are allowed to be on sick leave. The doctor’s assessment can be questioned by the Social Insurance Agency, but this is uncommon. The purpose of sick leave is to rehabilitate in order to regain your ability to work. Therefore, there must be a plan with the sick leave.
  • Some employers have special agreements (which you, in that case, have signed) that allow them to require a medical certificate on the first day of illness (so-called First Day Certificate). Then you need to get a medical certificate already on the first day of illness. This is only in those cases when you signed such an agreement. Your employer should then cover the cost of such a certificate.
  • If your workplace or duties are no longer suitable for you, it is your employer’s duty to adapt the duties so that you can cope with them.
  • Your employer cannot dismiss you for having diabetes. However, you may be dismissed if the disease makes it impossible for you to carry out work that the employer can offer. However, the employer has an obligation to try to relocate you in order to find suitable duties.
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