Listen to the audio version of this article (AI-generated).
Around 70% of people living with diabetes are of working age. For many, the hours spent at work are the hardest time to manage their condition. This year’s World Diabetes Day focus put a spotlight on how workplaces can either protect or undermine health, dignity and professional opportunity. Insights from lived experience, findings from an International Diabetes Federation (IDF) survey, the WHO Global Diabetes Compact and emerging research all point in the same direction: stigma is widespread, support is patchy, and meaningful change is overdue.
The IDF survey, which gathered responses from 1,400 adults living with diabetes in Argentina, China, Germany, India, Pakistan, South Africa and the United States, reveals how deeply fear and stigma shape life at work.
A proportion of respondents have never disclosed their diabetes to their employer. Others delayed disclosure even when diabetes was already affecting their working life. Nearly one in three have shared their condition with only one colleague, often as a safety measure rather than because they feel genuinely comfortable. When asked why they do not disclose, people living with diabetes repeatedly used the word “fear”: fear of being treated differently, fear of being passed over for promotion, fear of harassment, and fear of losing their job.
These fears are not abstract. Many respondents described very concrete negative experiences. Four in ten reported that they had experienced some form of bias at work because of their diabetes. Many felt judged when they took time to attend a medical appointment or to manage their blood glucose.
Many respondents described very concrete negative experiences. Four in ten reported that they had experienced some form of bias at work because of their diabetes
Tasks that are essential to staying well, such as checking blood glucose levels, taking insulin or eating at a specific time, were made more difficult by strict schedules, a lack of privacy, and workplace cultures that equate breaks with a lack of commitment.
The emotional toll is considerable. Just over two in five said that managing diabetes at work had harmed their mental well-being. One in three had considered leaving their workplace because of how they were treated. Together, these figures paint a picture of workplaces that are often poorly equipped to support basic diabetes care and, in some cases, actively undermine it.
Mark Tiller, an advocate and IDF Blue Circle Voice from the UK, recalled, “Apparently, the people in the room had been really uncomfortable with me injecting in front of them, and my employer asked if I could go to the toilets to do it in the future.” He also emphasised the role of education, “Almost all stigma is rooted in ignorance… whenever I get asked ‘Are you sure you can eat that?’ I choose to educate.”
Almost all stigma is rooted in ignorance… whenever I get asked ‘Are you sure you can eat that?’ I choose to educate
Lived experience stories add depth and humanity to these numbers. People living with diabetes know the challenges of managing glucose levels around time-pressured meetings, laboratory work, demanding travel schedules and major presentations. Before continuous glucose monitoring (CGM) was available, some described diabetes management at work as “haphazard”. Often, decisions were squeezed into moments between tasks. CGM has allowed some to anticipate and prevent low blood glucose episodes more confidently. Still, access remains uneven, especially in low-resource settings, and technology alone cannot fix a hostile culture.
As Anum Anwar, an advocate and diabetes educator from Pakistan, explained: “Instead of looking at my glucose levels or injecting insulin or having my meals on time, I had to think about running the experiment… we need our time, short breaks, and it’s not always doable.” She added, “You always have to monitor yourself, you have to carry extra things like insulin and a glucometer… it is demanding and challenging.”
You always have to monitor yourself, you have to carry extra things like insulin and a glucometer… it is demanding and challenging
Disclosure remains emotionally complex. Colleagues have asked people with diabetes to inject insulin in a bathroom or expressed discomfort at seeing someone check their glucose. Others described more positive encounters, where a single informed colleague, “a diabetes buddy”, became a lifeline.
Sylvie Maloof, co-Founder of the association DiaLeb and an IDF Blue Circle Voice from Lebanon, recounts,” During a strategic meeting, I felt fine as I stood up to present, completely unaware that my blood glucose was dropping rapidly. A colleague who knew about my diabetes noticed subtle changes in my colour and behaviour and realised I was experiencing severe hypoglycaemia. She acted quickly to get me something to treat it and prevented me from collapsing, and I will always be grateful for the calm and care she showed in that moment.”
What began as a frightening moment became an opportunity for understanding: at subsequent meetings, snacks were always available, even during Ramadan, to support her health needs while still respecting the broader context.
Flexibility is a recurring theme with diabetes management in the workplace. Sylvie also shared that after “a very tough night with persistent hypoglycaemia, I told my employer that I was going to work remotely. I am very blessed to work in an environment that is very flexible, very understanding.”
For many people living with diabetes, flexibility is not a privilege but a practical necessity that allows them to maintain their health. Yet such accommodations are far from universal. Some workplaces still insist on rigid hours and in-person attendance even when the COVID pandemic has shown that alternative models are possible in many sectors.
Research helps us understand the broader patterns that sit behind individual stories. A 2025 comprehensive review by Monash University examined 91 studies on diabetes and work. The findings confirm that diabetes can have significant consequences for employment.
People living with diabetes are more likely to leave work earlier, to experience work disability, and to spend more time off sick than their peers without diabetes. Even when present at work, they may struggle with “presenteeism”: continuing to work while unwell, often because they fear adverse reactions if they take time off. Shift work and night work present challenges, as irregular hours and disrupted sleep can make stable glucose management extremely difficult.
People living with diabetes are more likely to leave work earlier, to experience work disability, and to spend more time off sick than their peers without diabetes
Qualitative studies provide insight into everyday barriers. However, the evidence base is still limited in meaningful ways. Most studies come from high-income countries and formal employment settings. Researchers know very little about the experiences of people living with diabetes in low and middle-income countries, in informal or precarious work or in physically intensive roles such as agriculture, manufacturing or construction.
Few studies distinguish clearly between type 1 and type 2 diabetes, or between people using insulin and those who are not. Psychosocial factors such as diabetes-related distress, burnout and anxiety tend to be overlooked. Without this detail, it is hard to design policies and interventions that respond to the realities faced by most of the world’s workforce.
Despite these gaps, unmistakable messages have emerged. Workplaces that offer flexibility, privacy, access to snacks and medicines, and a culture of understanding can help people living with diabetes remain healthy and productive. Those that ignore these needs risk harming both their employees’ health and their own long-term performance.
Workplaces that offer flexibility, privacy, access to snacks and medicines, and a culture of understanding can help people living with diabetes
The WHO Global Diabetes Compact situates the workplace within a wider vision for diabetes care. Member States have committed to ambitious global targets for 2030, including diagnosing at least 80% of people living with diabetes, improving blood glucose and blood pressure control, increasing statin use among those at risk, and ensuring that all people living with type 1 diabetes have access to affordable insulin and self-monitoring. Achieving these targets depends not only on clinics and hospitals, but also on the environments where people spend their daily lives—including workplaces.
WHO has used its own institutional settings to model parts of this approach. Offices have hosted information booths, blood glucose testing and awareness events, and have worked with staff health programmes to encourage supportive workplace norms. At the core is the idea that awareness goes hand in hand with structural change. Education alone is not enough if scheduling, staffing, and performance expectations still make safe diabetes management impossible.
For employers, several practical areas offer immediate opportunities for change. The first is knowledge. Basic diabetes literacy across an organisation can reduce fear and misunderstanding. Staff should understand that diabetes is not a sign of weakness or poor self-discipline and that both type 1 and type 2 diabetes have complex causes, including genetics. Clear guidance on low and high blood glucose episodes, what signs to look for and how to respond in an emergency can help colleagues feel confident rather than helpless.
The second area is daily practice. Allowing brief, regular breaks for glucose checks, insulin administration or snacks can prevent dangerous fluctuations. Providing a clean, private space for these tasks respects dignity. Ensuring that people living with diabetes can carry and access their supplies easily, and store insulin safely, supports both safety and performance. Keeping fast-acting carbohydrate in a known location, with simple instructions, is a low-cost, high-impact measure.
Third, workplaces should consider culture and workload. Healthy workplaces do not celebrate long hours or constant availability, nor treat breaks as a lack of commitment. They encourage staff to raise health needs without fear. Offering more nutritious, culturally appropriate food options, or rethinking team-building activities, benefits everyone.
First aid and emergency planning also matter. Many organisations already train staff to respond to cardiac arrest or anaphylaxis. Updating these programmes to include diabetes scenarios, with proper training, can help colleagues feel prepared without turning them into clinicians.
Finally, people living with diabetes should be able to share information confidentially with human resources or a trusted colleague, without pressure to disclose more than they wish. Anti-discrimination policies and manager training must be active and meaningful, not just statements on paper.
Anti-discrimination policies and manager training must be active and meaningful, not just statements on paper
No one chooses to live with diabetes. No one should feel compelled to hide their condition at work for fear of losing their job, missing out on a promotion or being humiliated. People living with diabetes demonstrate resilience every day, balancing complex self-management with professional and family life. Their lived experience is not a liability but a strength—evidence of problem-solving, adaptability and persistence that any employer should value.
The World Diabetes Day focus on diabetes in the workplace is a call to action. It challenges employers to examine their policies, cultures and assumptions. It urges policymakers to integrate workplace realities into national diabetes strategies. And it invites colleagues to replace judgement with empathy and curiosity. With intentional effort, workplaces can become environments where people living with diabetes are safe, respected and able to thrive—not despite their condition, but alongside it.
D-Talk: Diabetes in the workplace
In this dedicated World Diabetes Day podcast, host Phyllisa Deroze welcomes three advocates from the IDF Blue Circle Voices network to explore how people with diabetes navigate challenges at work, such as disclosing a diagnosis and balancing self-care with professional responsibilities. The discussion also highlights the need for more inclusive, understanding and supportive work environments.
