IX. DIABETES AND EMPLOYMENT

Recommendations

• When questions arise about the medical fitness of a person with diabetes for a particular job, a health care professional with expertise in treating diabetes should perform an individualized assessment; input from the treating physician should always be included.
• Proper safety assessments for employment should include review of blood glucose test results, history of severe hypoglycemia, presence of hypoglycemia unawareness, and presence of diabetes-related complications but should not include urine glucose or A1C/eAG tests or be based on a general assessment of level of control.

Any person with diabetes, whether insulin treated or noninsulin treated, should be eligible for any employment for which he/she is otherwise qualified. Questions are sometimes raised by employers about the safety and effectiveness of individuals with diabetes in a given job. When such questions are legitimately raised, a person with diabetes should be individually assessed by a health care professional with expertise in diabetes to determine whether or not that person can safely and effectively perform the particular duties of the job in question.

Employment decisions should never be based on generalizations or stereotypes regarding the effects of diabetes. “Blanket bans” that restrict individuals with diabetes from certain jobs or classes of employment solely because of the diagnosis of diabetes or the use of insulin are medically and legally inappropriate and ignore the many advancements in diabetes management that range from the types of medications used to the tools used to administer them and to monitor blood glucose levels. For most types of employment, there is no reason to believe that the individual's diabetes will put employees or the public at risk. In certain safety-sensitive positions the safety concern is whether the employee will become suddenly disoriented or incapacitated. Episodes of severe hypoglycemia should be examined by a health care professional with expertise in diabetes to determine any impact on safe performance of the job.

Hyperglycemia is not typically a barrier to employment unless long-term complications are present that interfere with the performance of the job.

Most accommodations that help an individual with diabetes do his or her job may be provided easily and with little or no cost to the employer. Typical accommodations include breaks to test blood glucose, administer insulin, or access food and beverages. Some individuals may need leave or a flexible work schedule or accommodations for diabetes-related complications.

The ADA position statement on Diabetes and Employment should be consulted for more information on this topic.