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What needs to be taken into account in education and at work if you have diabetes?

Scientific support: Dr. Kurz Rinnert

Diabetes does not usually affect the choice of profession or existing job. It is rare for someone to be transferred or require training for another career for this reason. There are very few professions that are unsuitable for people with diabetes. Young people are able to choose almost any profession. Good blood sugar management is especially important at work, as low blood sugar levels can cause difficulties. Therefore, it is import to discuss the individual situation with the treating doctor.

Does diabetes have to be disclosed?

The condition must be disclosed if it would have an influence on the specific job. This is relevant if blood-sugar reducing  medication (for example, sulfonylureas, glinides) or insulin is being used, among other things. This is because severely low blood sugar levels can be a danger for the person affected and others around them. This may apply to the following jobs:

  • Transportation of persons (e.g., pilot of a small plane)
  • Monitoring and supervision with sole responsibility for the life of others (e.g., emergency doctors)
  • Use of firearms (e.g., special tactical police unit)
  • Work with a risk of falling or other dangerous workplaces (e.g., industrial climber)
  • Working in positive pressure conditions (e.g., professional diver)

If, on the other hand, the diabetes has no influence on the job, it is up to each person to decide whether to disclose the condition to their superiors or colleagues.

A disability or severe disability must only be disclosed if the contractually agreed activities cannot be carried out or can only be performed with significant limitations as a result of it. Severe disability is when the disability grade exceeds 50 percent.

Good to know:

Having to change jobs due to diabetes is very rare.

Apart from the legal aspects, it can be helpful to openly inform superiors and colleagues of the disease.  Misunderstandings or conflict situations can occur when someone tries to hide their blood sugar testing, injecting insulin, or dietary adjustment.

What should young people take into account when choosing a career?

When starting their career, all professions and activities that are suited to the person’s preferences, talents, and practical skills are viable options. Only serious complications and accompanying diseases could limit the choice. This is why the circumstances of each individual situation should be considered.

Innovative therapy options using continuous tissue glucose monitoring (CGM), training classes, and new types of medications help to improve treatment and enable individual adaptation of diabetes therapy to a job.

In education, type 1 diabetes need not affect the qualification pursued. Sometimes certain activities that are unsuitable for people with diabetes may be part of the education program but do not occur later in the everyday professional setting. In these cases, these parts of the training can be omitted.

Good to know:

The choice of professional career should be based on skills and preferences, not on diabetes.

Most performance-limiting or dangerous situations in the workplace are a result of low blood sugar levels. Furthermore, complications and accompanying diseases can make working more difficult. For example, diabetic eye disease affects the eyesight and cardiovascular disease can cause arrhythmia-induced fainting. People with type 2 diabetes may be limited by increased daytime sleepiness (sleep apnea), obesity, or high blood pressure.

Find out more about the complications and accompanying diseases of diabetes here!

The type of work can also pose a risk for people with diabetes. For people with constantly changing work days that are difficult to plan, blood sugar management can be particularly challenging.

Good to know:

Alongside low blood sugar levels, complications and accompanying diseases have the greatest effect on the ability to work.

In most cases, this answer to this question is “yes”. First, as part of the occupational health check-up, people with diabetes should check together with their company physician whether their diabetes will affect every day professional life. Sometimes only small adjustments are needed to continue to fulfill the previously assigned responsibilities. This also allows companies to maintain experienced employees.

In cases of type 2 diabetes, therapy with only lifestyle changes or medications that do not trigger low blood sugar levels usually have very little effect in the workplace. For people with diabetes who require blood sugar-reducing medication (for example, sulfonylureas. glinides) or who inject insulin, adjustments may have to be made. This also applies to people with type 1 diabetes. There are many different ways to adapt therapy to the requirements of the workplace. Measures such as continuous tissue glucose monitoring (CGM), training classes, new types of medications and insulins can be considered. Only after attempting these measures should training for a new career be considered.

In principle, diabetes is not a reason to terminate an employment contract. In companies with more than 10 employees, termination of an employment contract requires behavior-related, person-related, or operational reasons. Diabetes does not belong to any of these categories. Small companies with fewer than 10 employees are not subject to this protection against unfair dismissal.

People with severe disability status have special protection against unfair dismissal and can receive advice and support from the representative body for employees with severe disabilities.

Rehabilitation

In the case of acute or chronic disease, it may get to the point that a person no longer feels able to cope with the everyday routine in the workplace. To help people return to health and enable them to re-enter professional life, the German Pension Insurance Fund offers a comprehensive range of rehabilitation measures. Would you like to know what types of rehabilitation are on offer, what requirements you have to fulfill, and how you can apply for rehabilitation? Detailed information on the rehabilitation services of the German Pension Insurance Fund can be found here (Link in German).

Rehabilitation is especially crucial for children and adolescents with chronic diseases. Suitable measures can help children and adolescents overcome health-related problems and increase their chances of actively participating in professional life in the future. The German Pension Insurance Fund provides comprehensive information on rehabilitation services for children and adolescents (Link in German). 

Sources:

Deutsche Gesetzliche Unfallversicherung (Hrsg.) (2012): Leitfaden für Betriebsärzte zu Diabetes und Beruf. 2. Auflage. Berlin, ISBN: 9783864230554
Deutsche Rentenversicherung: Warum Reha? (Letzter Abruf: 17.08.2020)
Deutsche Rentenversicherung: Reha für Kinder und Jugendliche (Letzter Abruf: 17.08.2020)
Diabetes@Work: Fachärztliche Checkliste für eine arbeitstaugliche Diabetes-Therapie. (Letzter Abruf 29.08.19)
Institut der deutschen Wirtschaft Köln e. V.: Ich bin doch nicht aus Zucker! Wie sich die berufliche Teilhabe von Menschen mit Diabetes mellitus gestalten lässt. REHADAT Wissensreihe, 2016, Ausgabe 5
As of: 07.11.2019