Canadian HR Reporter

CANADIAN HR REPORTER November 2, 2015 8 NEWS Combating diabetes in the workplace It can mean sizeable drug costs along with disability claims and accommodation requests — but there are solutions, say participants at a recent roundtable BY LIZ BERNIER IT'S a condition widespread enough to be almost common- place, yet many employers still aren't doing much to address one of the most prevalent health problems in the workforce: Diabetes. So Canadian HR Reporter hosted a special roundtable in Toronto, moderated by lead edi- tor Sarah Dobson and sponsored by Sun Life Financial, to take a deep-dive look at the issue. "When we know that 3.4 mil- lion Canadians are suffering from diabetes, that's a huge number," said David Satok, corporate med- ical director at Rogers Commu- nications in Toronto during the roundtable. When you account for those with pre-diabetes as well, the total jumps to a startling nine million people, he said. "at's a huge burden to soci- ety — and to the individual, it's an incredible impact. So we have to think about the individual, about society, about the workplace and all kinds of (factors)." It's clear this is a significant na- tional problem, said Shana Kapus- tin, director of human resources at SYNNEX Canada in Toronto, a wholesale computer distributor — and it's also quite a pricey one. "For the last five to seven quar- ters, it's consistently been our highest drug use," she said. "And if we don't start doing things such as education, prevention, main- tenance, this will only get worse." ere has already been an in- crease in cases of diabetes, ac- cording to Seema Nagpal, director of public policy at the Canadian Diabetes Association in Ottawa. "e stats would show that be- tween 2000 and 2010, the popu- lation with diabetes doubled in Canada from 1.3 million to 2.5 million. And today, it's at 3.3 mil- lion," she said. "So it's increasing every day. Twenty-nine per cent of the population has diabetes or pre- diabetes, and we expect that to continue to rise — unless we continue to pursue these preven- tion programs which have been shown to decrease the impact of diabetes." What exactly is diabetes? So, what does diabetes actually do to the body? Simply put, diabetes means there is chronically elevat- ed sugar in the bloodstream, said Satok. "I think about sugar as the fuel for the cell, and everything we eat turns into sugar that can actually power the cell so that we can func- tion," he said. "e problem with diabetes is there's actually too much fuel cir- culating through the system. And the way I describe this to patients is if you think about sugar in your blood vessels, in your blood, as kind of like brine, so salt in water… if you put a cucumber in brine for long enough, you get a pickle. Well, diabetes is like that. When we have constant and chronic high sugar levels, that affects our tissues… we essentially pickle our organs." Generally speaking, there are two main types of diabetes: Type 1 and Type 2, he said. "We think about Type 1 diabe- tes, which is the insulin-depen- dent diabetes that is really related to a lack of insulin in the system," he said. "So if we don't have enough in- sulin in our system and we can't get sugar into the cell, it's a really weird situation, because it's like we have all this fuel but it can't get into the engine. We need that key, that insulin, to allow it in. So Type 1 diabetes, we don't have that in- sulin to allow it into the cell." Type 2 diabetes unfolfs differ- ently, he said. "Type 2 diabetes is that type of diabetes (where) there's a lot of in- sulin and there's a lot of cells, but they don't interact well. It's kind of like the key and the lock don't re- ally work very well — so there's a sense of resistance. "And for some people, there's actually a lack of insulin as well. So there's a bit of a problem in two areas for Type 2 diabetics." In terms of the breakdown of diabets types by population, the number of people with Type 2 dia- betes far outweighs the number of people with Type 1, he said. "It's probably about 90 per cent, 95 per cent Type 2 and five per cent, 10 per cent Type 1." ere are other variants of dia- betes as well, said Nagpal. ere's also a temporary condition called gestational diabetes. "(at) occurs in about 18 per cent of pregnancies. It's a tem- porary condition that affects women and it goes away after the pregnancy is complete. But it places women and the children at higher risk for Type 2 diabetes in the future." Impacts include fatigue, absenteeism, mental health issues e impacts of diabetes can mani- fest in the workplace in terms of productivity, said Valerie Taylor, chief, general and health system at the Centre for Addiction and Mental Health in Toronto. "You're fatigued, you can't con- centrate as well, you just have a lot of physical difficulties and you can just get a lot of burnout. People start to become really frustrated with the fact that they have this chronic condition that we have good treatments for, but we cer- tainly have no cures," she said. Employees will probably also need to take steps to manage the condition throughout the work- day, said Nagpal. "A person (may need) to moni- tor their blood glucose — that can be self-monitoring in the work- place — as well as take insulin by injection or through an insulin pump. A person may also need to have regular snacks throughout the day at the workplace. Some- times, in cases of hypoglycemia, they need to treat their blood sugar throughout the day." Because the treatments for diabetes have improved so much, there are many more people with the condition in the workforce, said Taylor. And that can cause significant costs in terms of ab- senteeism and presenteeism. "ey're going to be at work, because their medications have allowed them to be and that's great, but if we haven't done oth- er things to help them function at an optimal level, we haven't helped them to get their illnesses under control, they're going to be there but they're not going to be focused. ey're not going to be able to work at their full level of capacity," she said. "ose are significant costs to the employer, but also detrimental to the employee as well because people don't want to be at work SPONSORED BY SELF-DISCLOSURE > pg. 9 "People don't want to be at work and be fatigued, and not be able to produce the way that they know they're capable of. So that impacts morale."

• Cover