Working with your employer when you're living with T1D

Letting your employer and coworkers know you're living with type 1 diabetes (t1d) can feel a bit tricky. You don't want to be seen as different or less capable because you're not. At the same time, a little accommodation in the workplace can go a long way to make living with t1d easier. We're here to help break down what accommodations may be available to you as well as some tips on how to talk about living with t1d at work.

The Americans with Disabilities Act

The Americans with Disabilities Act (ADA) Amendment of 2008 prohibits discrimination against people with a variety of health conditions, including diabetes. During the job interview process, potential employers are prohibited from the following:

• Asking if you have diabetes
• Asking about your treatment for diabetes
• Asking whether you take prescription medications or use insulin

If you voluntarily reveal that you're living with diabetes during the interview process, your potential employer may ask if you'll need any reasonable accommodations, but they may not ask any other questions.

After extending a job offer, an employer may ask a candidate to complete a medical form and/or to have a medical exam, but the employer must ask this of all applicants offered the same job. An employer may only withdraw a job offer upon discovering that offering a candidate a job will pose a significant risk to the candidate or the workplace and that the danger cannot be eliminated with reasonable accommodations.

After employment, what can my employer ask about my diabetes?

The rules on what an employer can ask you regarding your t1d change slightly once you're employed. If an employer observes performance problems they believe may be related to a health problem, they may ask questions or require you to have a medical exam. If you take medical leave, your employer can ask you to bring a doctor's note clearing you to return to work. Lastly, your employer may ask questions about your diabetes in order to support your request for reasonable accommodations.

Employee accommodations for people with diabetes

Reasonable accommodations are any changes needed in order for you to take care of your diabetes while you do your job. The intent of the ADA is to ensure that people with medical concerns are on a level playing field with everyone else. Some common reasonable accommodations for people living with t1d include, but are not limited to, the following:

• The opportunity to test blood sugar and inject insulin any time and anywhere at work
• A private place to test blood sugar and inject insulin, if preferred by the employee
• Breaks on an as-needed basis to check blood sugar, eat a snack, or inject insulin
• The option to sit on a stool or chair instead of standing (for people living with diabetic neuropathy)
• An extra-large computer monitor (for people living with diabetic retinopathy)

Requesting reasonable accommodations at work

Although the ADA doesn't require you to submit a written request for accommodations, it's always a good idea to put your request in writing right off the bat. Your employer may also have a formal process for requesting accommodations — you can check your employee handbook first to find out. If there is no formal process, submit your request to your employer's human resources (HR) department by email or on paper, and use these tips to ease the process:

• Keep a dated copy of any paper you submit to HR
• Be specific about what you need (i.e. "I'm requesting a 24-inch computer monitor as a reasonable accommodation for my diabetic retinopathy")
• Include a statement from your healthcare provider with your request
• If your employer has trouble understanding your need for accommodation at first, you can educate them on the ADA and consider referring them to the nonprofit Job Accommodations Network

Living with t1d doesn't make you any less capable as an employee, and you deserve every opportunity to advance your career. Work with your employer to ensure that you get the reasonable accommodations you need to help you succeed in the workplace.

Talking to colleagues about T1D

Some people living with t1d choose to keep their diagnosis private. Others decide to tell their colleagues because they want the security of knowing that if they have a blood glucose emergency, a co-worker will be able to assist them or call EMS. The choice is yours. Your employer cannot legally reveal your diagnosis to your co-workers, even if someone observes you injecting insulin and they question your employer about it.

If co-workers do observe you injecting insulin or checking your blood sugar, they may question you about it. People are naturally curious, so it may help to think of the questions more as an opportunity to educate them and less as an intrusion into your personal business. If you run into someone who asks more questions than you'd like to answer, be ready with a response such as, "I love your curiosity, but I really need to get back to work right now."

If you want to learn more about working and living with t1d, check out this article on the best ways to talk with your boss about concerns around diabetes and COVID-19.