Diabetes in the workplace


I have been a type 1 diabetic for almost 11 years. I have been with my employer for 10 years (accounting) and have always been open about the fact that I'm a diabetic. I am brittle but I have only needed assistance once to recover from a low and I was at home. (It was overnight)

My employer requires an annual physical. You can choose to have one with your own doctor or have one done the medical director (I'm in healthcare). I opted to have the mini exam done with our medical director just to get it out of the way.

We have to complete a form with four questions. One question asks: Do you use any medication that could impact your work performance. I checked yes to be honest. When the medical director asked me what I was taking and why it could impact my work I told him insulin (via pump) due to type 1 diabetes and low blood sugars could affect my performance. He told me that the only time insulin causes low blood sugars is when it is misused. Then he wrote "only when misused" on my questionnaire. We argued the point but he would not take his comment off my form.

My questions/concern:

My concern is that if I were to have a low at work and I were to fall and/or pass out and injure myself (even a minor injury) that my employer could use this exam as grounds to fire me stating 'I was misusing prescription medication at work."

Do I fight this now rather than have it become an issue later? Do I have my Endo (who I have seen for 6 years) write a letter to include in my file explaining diabetes better? Am I overreacting? I just want to make sure I am protected.

Thanks for your input!

Wow… Jess, I’ve never heard that before and am intrigued by it. Though angry that it has come to be for you. Any doctor or person living with diabetes knows this to not be the case, and this person is clearly wrong. I’d argue it now, getting a letter and taking it to my boss/supervisor and also the HR supervisor to 1.) contest the comment on the form; and 2.) include in the file specifically to either have the form comment removed or to just include. Not sure if it’s also needed, but the ADA does have an advocacy arm that might be able to discretely offer some assistance as far as employment issues and potential discrimination. I’d welcome the chance to hear how this plays out, if you’re willing to share it.

That is terrible Jess. Nothing gets me quite as worked up as supposed medical professionals making these type of judgements and refusing to even consider that they may not know quite as much as they think they do. I would fight it as well. Not only to protect yourself but to hopefully disabuse this medical director of his erroneous beliefs. I too would love to hear how this plays out if you are willing to share.

“Do you use any medication that could impact your work performance?.” I would say no. I do agree that there is a probability that things can go bad and there a far greater chance that things don’t go bad. I am hoping that your job doesn’t involve training for the next Olympics or attend a Navy Seals training. ( I am not saying that diabetics cannot accomplish either of them . I am pretty sure some diabetics have already attempted and succeeded in both.)

I mean has any government agency done research to indicate that diabetes reduces brain activity or logical comprehension. I don’t think so. I mean the cops allow us to drive car as along as we can prove them that our A1c is under control (medical reports have to be submitted once in two years to support the fact that things are under control.) So I don’t see why i should say Yes to that question.

“Things getting worse for Diabetes is a condition of probability.” In simple words people loose more working days in a year due to common cold, flu, head aches, fever, ear infection than due to Hypos (in most cases we recover in an hour.)

I would dispute this now & you’re not over reacting. I’d strongly push to have the company doctor’s assessment removed from your file & replaced with one from your personal doctor. You’ve got 11 years of performance to back up your position.

Hopefully, there’s something in your company’s employee manual that can be used to your advantage to contest this, or a policy that allows for an ammendment of your medical profile. I don’t think a letter from your endo is enough because one doc’s opinion against another’s may not be enough to protect you.

I really would not lose sleep over this. This medical director really does not understand diabetes. First, pump therapy does reduce the chance of hypoglycemia. That said all diabetes therapy runs the risk of hypoglycemia. This can come from miss calculating carbs/ insulin, to much physical activity, meal skipping etc. These condition have nothing to do with misuse of insulin. If god forbid you did experience a low and fired any expert in the science of diabetes will agree the causes of hypo glycemia are many and as long as you show that you are active in your care your chances of hypoglycrmia are the same as a co-worker experiencing many of the unexpected thing that occur to us during the course of the day.

I’m wondering why a physical is required at all for your job. If my employer asked about my medical issues, I would say, “That’s my own private business.” I also don’t think diabetes significantly affects non-physical jobs. If it did, then perhaps it would be the employer’s business b/c they may need to make a reasonable accommodation. I think that’s what your medical director was getting at with his comment about misuse of insulin: that you don’t need any accommodations. Sounds like corporate CYA…

Hi Grego, just to answer your question about medical physicals and non-physical jobs. Many corporations have started workplace wellness programs. These programs usually get started by the group insurance provider. The basic concept is to determine the workplace’s “wellness” and if the company scores good, then they could qualify for insurance discounts. Some insurance companies will even discount just for starting a workplace wellness program.

I had this happen at my last corporate desk job. Their program was on a volunteer basis, but I can see some companies requiring it due to the discounts that can be received.

As for Jess, I would get a copy of the assessment and make sure that at the VERY least it is mark that the prescription medication is insulin, something that is required. The last thing you would want to some vague note about misuse of prescription medication in your file. Then I would do as others suggested and get a letter from your Endo and take it to the HR department.

No, I would not make an issue of this. He can write whatever he wants. If and when the time comes that your employer blames you for a low, etc., you would have the facts and the law on your side. I would explain symptoms of lows and what to do in case of emergency to my immediate supervisor and trusted coworkers, emphasizing that this would be a rare occurrence and may never happen but what to do in case of a low blood sugar episode for your own safety.

The problem is employers use medical professionals’ advice all the time to know how to handle employees they think are abusing substances, misusing substances, or poorly performing at work due to these issues, to put them through disciplinary action, and up to including termination… And the ADA protects an employer when these things are put in writing by a medical professional. Yes you SHOULD lose sleep at night over this. I am an HR professional. He needs to go discuss it with his HR Manager, and with his Endocrinologist ASAP.

Did you have to sign the form? I personally would not want it to go down on record in its current form. He clearly wants something down to cover his own a**, but I think that “misuse” is a completely inappropriate term. See if you can find a term or phrase that you can both agree on, one that clarifies the point that lows are sometimes unforeseeable (misjudged based on unforeseen circumstances, something like that). A letter from your endo wouldn’t hurt.

But I wouldn’t worry too much. Like Jan said, his opinion is contrary to the field and would not hold up under any weight. The importance of this, in part, depends on what recourse short of litigation you have should they decide to terminate you. It would be much better if you have some ability to appeal things internally.

Do something now. It is naive to think it is no big deal or doesn’t require an immediate response. You may not be able to get the remark stricken but you can at least add your own documentation to the effect that insulin might affect your performance even if it is ‘used as directed or used as intended.’

Hopefully, it will never come up during the course of your employment. But if it does come up your failure to speak up now will be used against you. Count on it.

After you paper your own file, and only after, can you forget about it.

And next time, use your own doctor instead of the employers medical flunky. :slight_smile: (Nothing personal, doc.)


Fight it. That “doctor” knows very little about how insulin works. I do not misuse my insulin and yesterday I had a very strange situation with two lows happening very close together. No active insulin other than basal at the time. My carb count for my lunch had been exact. Fight this. From a legal standpoint, it looks like he’s making pretextual reasons for future consideration if they want to make an adverse personnel action against you.

I actually would’ve said no to the question (i’m a type 1 on insulin too). It’s part of the disease, but not just due to medication. However, I wouldn’t want to sign it with his notes either. Odd that he did that.

Good points, but it’s still better to have a job than to have a lawsuit, IMHO.
If they’re covering their butts, the employee should also cover hers!.

Diabetes is defined as a disability in the Americans with Disabilities Act and you employer needs to provide accommodation for you to work in your position in the workplace. This include the appropriate medical assessment of D in your record.

Although I have a disability, with insulin and BG testing I can perform as well or better than anyone I work with. I was denied a job 38 years ago because I am a T1D and was told “You can’t do the job and work here.” In a way that is almost funny, but since then, anyone who makes statement, judgement or action that shows that they do not understand T1D, the “EDUCATE ME” tattoo on their forehead glows green and I proceed to educate them about Diabetes.

Despite what others wrote the question “Do you use any medication that could impact your work performance” can only be answered with yes. As a result of a mistake of course and I think this is exactly what the medical director had in mind. He just picked the wrong word “misused” which is very near to “abused” or “intentional”. So to clarify this I would explain my discomfort and the interpretation this allows to the director. I would ask him to change the wording to “Patient is trained to simulate the pancreas by several injections of insulin per day. An influence on the work performance is unlikely and can only happen in case of a miscalculation of the dosage by human error” or something like that.

I believe you answered wrong, the drug doesn't cause problems the disease does. And I don't know about where you live but here in Virginia, USA, that could easily be considered work-place prejudice and you could maybe "retire" with a bundle of $$.

The real problem will come for all of us when they get government health care approved and diabetes is considered too rampant and too expensive for full coverage. That will be a larger problem that high and low BGs.