Diabetes Self-Management at Work: A Checklist for Clinicians

Managing diabetes in the workplace remains a significant but often overlooked challenge for many adults living with the condition. New global data from a survey of nearly 10,000 workers across 11 countries show that more than one in three people with diabetes report heightened job-related stress tied to daily management demands.

Despite the fact that roughly 70% of the world’s 590 million adults with diabetes are of working age, support in professional settings remains limited: 42% cite workplace-related anxiety, 79% report encountering bias or misunderstanding, and more than one in five choose to conceal their condition at work. These pressures can directly affect glycemic control, treatment adherence, and psychosocial well-being—issues that clinicians may not routinely explore during diabetes visits.

This checklist is designed to help healthcare professionals quickly assess workplace-related barriers, identify risks, and integrate practical, patient-centered strategies into routine care.

1. Work Environment Assessment

Ask during history or review of systems:

• What kind of work do you do? Typical hours, shift patterns, physical demands?
• Can you take breaks for meals, snacks, or glucose checks when needed?
• Do you have access to a private or clean space to test glucose or administer insulin?
• Any safety concerns (e.g., operating machinery, driving, exposure to temperature extremes)?
• Does your employer or supervisor know about your diabetes? How comfortable are you with that?

2. Diabetes Self-Management at Work

Review practical issues:

• Frequency of blood glucose checks during work hours
• Timing and reliability of meals/snacks
• Ability to treat hypoglycemia/hyperglycemia promptly
• Medication storage (e.g., insulin refrigeration or pen safety)
• Impact of job stress, physical activity, or irregular hours on glucose control

3. Psychosocial Screening

Incorporate brief screening for:

• Diabetes distress (ask: “How much does diabetes interfere with your work life?”)
• Anxiety or depression related to managing diabetes at work
• Fear of hypoglycemia during tasks or meetings
• Stigma or discrimination experiences
• Social support from coworkers or supervisors

4. Clinical Considerations

• Adjust insulin or medication timing for shift work or long hours.
• Address intentional hyperglycemia (eg, maintaining high glucose to avoid lows at work).
• Reinforce recognition and management of hypoglycemia, particularly for those who conceal their condition.
• Screen for complications that could affect job safety (neuropathy, retinopathy, hypoglycemia unawareness).
• Document in the medical record any job-related barriers that may require written accommodation support.

5. Action Planning

• Develop a brief Workplace Self-Care Plan with the patient:
  • Ideal meal/snack timing
  • When/where to check glucose
  • How to handle hypoglycemia at work
  • Emergency contact or alert system
• Offer information on reasonable accommodations (ADA or local equivalent).
• Provide written resources for disclosure and employee rights.
• Encourage discussion with occupational health or HR if issues persist.
• Revisit these topics during follow-up or when employment changes.

6. Provider Follow-Up Notes

• Was workplace support discussed? □ Yes □ No
• Are barriers to diabetes management identified? □ Yes □ No
• Plan for referral (psychology, social work, occupational medicine, diabetes educator)? □ Yes □ No
• Review at next visit (3–6 months or earlier if new job/shift).

Quick Reminders

• Ask before advising: the patient knows their workplace best.
• Even small accommodations (extra 10 minutes for lunch, mini fridge access) can improve adherence.
• Encourage balanced disclosure—patients need not share every detail, but transparency can prevent emergencies.
• Psychosocial stress at work is as clinically relevant as diet or medication adherence.

Sources and Recommended Reading

• American Diabetes Association. Standards of Care in Diabetes—2025: Diabetes and employment. Diabetes Care. 2025;48(Suppl 1):S287–S292.
• Butler K, Schatz D, Hathaway K. Workplace checkup: keepign patients with diabetes employed and safe on the job. Clin Diabetes. 2014;32(1):44–48. doi: 10.2337/diaclin.32.1.44
• Dimmick BL, Douglas D. Reasonable Accommodations for Diabetes Management in the Workplace. American Diabetes Association; October 2023. Accessed November 5, 2025. https://diabetes.org/sites/default/files/2023-10/reasonable-accommodations-for-diabetes-management-in-the-workplace.pdf
• Powers MA, Bardsley JK, Cypress M, et al. Diabetes self-management education and support in adults with type 2 diabetes: consensus report of the ADA, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, and the American Academy of Family Physicians. Diabetes Care. 2020;43(7):1636–1649. doi:10.2337/dci20-0023
• Young-Hyman D, de Groot M, Hill-Briggs F, et al. Psychosocial care for people with diabetes: position statement of the American Diabetes Association. Diabetes Care. 2016;39(12):2126–2140. doi:10.2337/dc16-2053
• Leorbroks A, Nguyen XQ, Vu-Eickmann P, et al. Psychosocial working conditions and diabetes self-management at work: a qualitative study. Diabetes Res Clin Pract. 2018;140:129–138. doi:10.1016/j.diabres.2018.03.023
• Olesen K, Cleal B, Skinner T, Willaing I. Characteristics associated with non-disclosure of type 2 diabetes at work. Diabet Med. 2017;34(8):1116–1119. doi:10.1111/dme.13347
• Hansen UM, Skinner T, Olesen K, Willaing I. Diabetes distress, intentional hyperglycemia at work, and glycemic control among workers with type 1 diabetes. Diabetes Care. 2019;42(5):797–803. doi:10.2337/dc18-1426