Chronic disease is becoming an increasing part of Australian life. Over 7 million Australians have at least one chronic condition and 4 out of 10 people have three or more risk factors for chronic disease.

Our Chronic Disease Snapshot finds that “the global burden of chronic disease is increasing rapidly,” and, “in Australia, the burden of chronic disease and its consequent effect on disability and death is growing.” Diabetes is the sixth leading cause of death in Australia.

Work-wise, people without chronic disease are more likely to be in full-time employment compared with those with chronic disease (61 per cent vs. 48 per cent). People suffering from chronic disease take almost twice as many days off work and are less productive when at work (presenteeism).

While there is no national analysis of the impact of diabetes on our economy, the cost of diabetes to the healthcare system alone is at least $3 billion.

Left unchecked, the risk factors for diabetes can threaten the health of your workers and the productivity of your business.

On the other hand, assisting employees to lessen the risk of developing diabetes or to better manage diabetes if they have it, has significant benefits. It helps your employee, improves productivity and has the indirect benefit of creating a great place to work.

What is Diabetes?

Diabetes occurs when the body’s ability to either produce or effectively use insulin becomes impaired.

Insulin is a hormone that enables the body to absorb glucose and move it from the blood stream into the cells where it is needed. Glucose provides energy for muscles and other tissues. Without insulin, the cells can’t access the needed glucose and the energy it provides. Instead, the glucose stays in the blood and is lost through the urine.

People with diabetes must monitor their blood sugar level to ensure their sugar levels are stable. High blood sugar - hyperglycaemia, is common to both main types of diabetes. Low blood sugar, or hypoglycaemia, can occur when a person receiving insulin has too much insulin in their system for their sugar levels, and their sugar levels are too low.

Type 1 Diabetes

Type 1 diabetes is caused by a combination of genetic and environmental factors, both of which are still largely not known. In type 1, the pancreas stops producing insulin and as a result the body burns fat for the energy it is not getting from glucose. This is dangerous for the body, and without treatment people die.

Type 1 is a life-long disease, usually developing in children and youth. There is no cure; people must use up to six insulin injections every day to ensure their blood sugar levels don’t get too high.

If any of your employees have type 1 diabetes, you should be aware of the symptoms of low blood sugar. According to Diabetes Australia, they are:

• Rapid breathing;
• Flushed cheeks;
• Abdominal pain;
• Sweet acetone (similar to paint thinner or nail polish remover) smell on the breath;
• Vomiting; and
• Dehydration.

If you see any of these symptoms, ensure your employee is given medical treatment immediately or an ambulance is called.

Type 2 Diabetes

This is the most common form of diabetes and accounts for 85-90 per cent of all cases of diabetes in Australia. Type 2 diabetes is the result of either the pancreas not providing sufficient insulin, or the body not being able to use the insulin effectively.

Though the risk of developing type 2 diabetes is linked to genetic predisposition, lifestyle risk factors also play a significant role. They include:

• Obesity;
• Lack of exercise;
• Poor eating habits; and
• High blood pressure.

It is estimated that up to 60 per cent of type 2 diabetes could be prevented or delayed by avoiding these risk factors.

Some risk factors for diabetes cannot be modified. These include:

• A family history of diabetes;
• Over 55 years of age;
• Being of Aboriginal or Torres Strait Islander background;
• Having a Pacific Island, Indian subcontinent or Chinese cultural background; or
• Being a woman who has given birth to a baby over 4.5kg (9 lbs), or had gestational diabetes when pregnant, or having a condition known as Polycystic Ovarian Syndrome.

It’s vital that people are aware of the risk factors of type 2 diabetes and modify their lifestyle if they are at risk. When people develop type 2 diabetes, they also increase their chances of suffering:

• Kidney disease;
• Cardiovascular disease;
• Blindness;
• Nerve damage;
• Amputation;
• Shortened life; and
• Death.

Symptoms to watch for

Circulate emails, organise information sessions or speak one-to-one about the importance of recognising the symptoms of type 2 diabetes. According to Diabetes Australia, these symptoms can be signs that someone has developed type 2 diabetes:

• Being excessively thirsty;
• Passing more urine;
• Feeling tired and lethargic;
• Always feeling hungry;
• Having cuts that heal slowly;
• Itching, skin infections;
• Blurred vision;
• Gradually putting on weight;
• Mood swings;
• Headaches;
• Feeling dizzy; and
• Leg cramps.

Preventing diabetes

Diabetes Australia suggests that people can delay and even prevent type 2 diabetes by:

• Maintaining a healthy weight;
• Regular physical activity;
• Making healthy food choices;
• Managing blood pressure;
• Managing cholesterol levels; and
• Not smoking.

How do you encourage this in the workplace?

Implement programs that encourage your employees to pursue fitness and healthy living. Some suggestions from our cardiovascular disease fact sheet include:

• Free employee health risk-assessment screening programs;
• Low-cost heart-healthy eating options at the workplace cafeteria;
• Treatment programs including medical or fitness guidance and health counselling;
• A smoke-free workplace policy;
• A “lunch club” program for workers that involves workers collectively buying bulk fresh ingredients to make their own low cost healthy lunches with at work;
• Promote physical activity by allowing employees to use company time and/or facilities for exercise, or partner with local health facilities and subsidise/ incentivise employee membership;
• Hold walking-meetings;
• Promote intra-office walking and stair use by centralising office equipment and encouraging in-person communication;
• Provide staff pedometers;
• Encourage teams events, such as http://www.gettheworldmoving.com; and
• Stress management programs. Target stress risk factors by making counselling and physical therapy sessions regularly available to employees;

Employing people with diabetes

All of this information doesn’t mean you should avoid employing people who suffer from diabetes. If somebody has learned to live with type 1 diabetes for example, they may lead generally healthier lives and be in more regular contact with medical advice than your other employees.

The main thing is to talk with prospective employees about diabetes and understand their requirements and work restrictions.

More info

Diabetes Australia

Diabetes Victoria