By Brian Kreissl
As in most Western countries, Type 2 diabetes is reaching epidemic proportions in Canada. With the aging population, increasing rates of obesity and our largely sedentary lifestyle, the problem is likely to get worse before it gets any better.
Enhancing awareness of this increasingly common condition will help employers develop wellness programs designed to prevent or delay the onset of diabetes, help employees who become diabetic manage the disease and reduce the likelihood of complications, as well as helping employers meet their duty to accommodate under human rights legislation.
What is type 2 diabetes?
There are a lot of misconceptions surrounding diabetes, with many people failing to make a distinction between type 1 or juvenile diabetes on one hand and type 2 or adult onset diabetes on the other. Generally, type 1 diabetes is when the pancreas is unable to produce insulin at all, while type 2 diabetes occurs either when the patient’s pancreas fails to produce enough insulin, or when their bodies become resistant to insulin.
While type 1 is generally considered to be the more “serious” form of the disease, type 2 diabetes can also lead to serious complications and is far more prevalent than the juvenile form of the disease. This focus here is on type 2 diabetes.
While both types of diabetes can lead to insulin dependency, patients with type 2 diabetes are often able to manage the disease through diet, exercise and (possibly) weight loss — at least initially. However, many patients with type 2 diabetes require one or more oral medications to help reduce insulin resistance. As the disease progresses, they may eventually need to go on insulin to control their blood sugar.
Diabetes is a disease characterized by high blood sugar levels (hyperglycemia). This can occur after eating or even first thing in the morning when the patient has been fasting for several hours. This is because the liver secretes glycogen, a type of carbohydrate, even when we’re sleeping.
While some diabetics occasionally suffer from very low blood sugar (hypoglycemia) that is generally a result of the medication they take to manage their diabetes – especially insulin. Generally, the problem is blood sugar that’s too high, not too low.
Over time, high blood sugar damages blood vessels and can lead to complications such as heart disease, stroke, kidney failure, amputations and blindness. With diabetes, it’s the complications, not the disease itself, that are most worrisome.
Another common misconception is diabetes is caused by eating a lot of sweets, or that diabetics only have to restrict their intake of sugars. In fact, all types of carbohydrates will cause blood sugar to rise. A large plate of pasta, for example, may cause a larger spike in blood sugar than a chocolate bar. And most experts believe eating sweets doesn’t directly cause diabetes.
Diabetics are often able to manage the disease largely through healthy eating. Fortunately, a healthy “diabetic” diet closely resembles a diet that’s considered healthy for everyone.
Diabetics can help lower their blood sugar by limiting the amount of carbohydrates they consume, eating more foods with a low glycemic index and consuming a diet that’s high in fibre. It’s also beneficial to get regular exercise, which can help reduce insulin resistance, improve circulation, lower blood pressure (high blood pressure can cause strokes and damage kidneys) and improve overall cardiovascular health.
Many diabetics also find their blood sugar can be dramatically reduced by losing weight. Diabetic patients who are able to lose 60 or 80 pounds can sometimes even experience a complete remission and be able to discontinue their medication, at least for a few years.
However, it’s important not to stigmatize people with diabetes or assume all type 2 diabetics are obese and can “cure” their condition simply by losing weight. People with a family history of the disease can become diabetic even if they maintain a healthy weight. And many people who are overweight or obese will never become diabetic.
Accommodating employees with diabetes
The following are some suggestions to help employers accommodate diabetic employees in the workplace:
•Ensure healthy options are available whenever food is served in the workplace.
•Help employees avoid and manage stress (which can cause high blood sugar and high blood pressure).
•Encourage physical activity through gym memberships, on-site facilities or walking clubs during lunch hours.
•Provide regular breaks; discourage employees from skipping meal breaks.
•Foster a culture that encourages a healthy work-life balance.
•Encourage employees to get regular health checkups.
Brian Kreissl is the managing editor of Consult Carswell. He can be reached at brian.kreissl@thomsonreuters.com. For more information, visit www.consultcarswell.com.