The most fun thing about having diabetes is the fact that it goes with you everywhere, all the time. Just kidding, that’s the worst part about it. It’s with you when you sleep, when you go for a run, when you meet up with friends for a drink, and when you clock into work. After having managed diabetes and my own schedule for many years while in school, I can remember feeling extremely nervous about the idea of managing my type 1 diabetes while having a full-time job. 

Some of the thoughts and concerns running through my head included: 

• What if I have a low at a bad time?

• What if my pump or diabetes tech goes off in an important meeting and embarasses me? 

• What if I need to eat at a time where it’s inappropriate to do so, or I need to leave a meeting because it’s running long and my blood sugar is dropping?

• What if I’m put in a position where I have to explain my diabetes to someone and I don’t want to?

• What if people don’t understand, or worse, exclude me? 

• What if I get sick and it takes longer to recover than everyone else and people get upset or doubt that I’m actually sick?

If you’re worried about some of these things as a person with diabetes starting their first job or as someone who was newly diagnosed recently, you’re not alone. Almost all of the concerns on the list above have happened to me over the years, and I’ve had the opportunity to think about what I would do the same and differently in the future. I’ve had diabetes while working a bunch of different jobs, including fast food, manual labour, and office work. Below are some of my tips that have helped me stay a good employee while also prioritizing my diabetes. 

1. Decide how much you want to tell people in advance, but be flexible 

A lot of the advice out there about managing diabetes at work involves giving your manager and teammates a heads up about your condition, however, this is up to you and what you feel comfortable with. I usually let a few key people know—my manager, a desk mate—so they’re aware in case something happens, but I prefer not to openly talk about it beyond that. Know that some people will ask questions if they see your technology or other diabetes activities, but a simple “it’s a medical device” and a smile will do if you don’t feel like sharing with everyone. 

2. Have backups of everything in your office or bag 

If you’re working in an office or outside of your home, the next thing to do is to make sure you have backup supplies of everything so you’re ready in an emergency. I keep an extra insulin pump site change, alcohol swabs, a Dexcom site change, a vial of insulin (ideally in an opaque bag in the fridge), low supplies, pump batteries (if your pump uses batteries), and spare syringes. This way you can quickly handle anything that comes up without needing to leave. 

3. Provide context about your specific situation 

One of the biggest tips that I give to people who have been newly diagnosed is that it’s important to lay the groundwork and give your manager a brief overview of what diabetes is and what you might need. Don’t assume that they have any knowledge of the condition. I always like to highlight that I might need an extra break or two on days where my blood sugar is high or low, there might be occasional beeping coming from my phone or pump that I can’t turn off, and there may be times where I’m away for a few days because of sickness. The sickness thing is a big one to mention—I don’t get sick often, but when I do, it usually hits me harder than it would an average person and I might get knocked down for longer than expected. If your boss knows this in advance, it can avoid any awkward conversations about why you need three days off to manage a stubborn cold that’s impacting your diabetes. I’ve luckily never had a boss give me a hard time about sickness and diabetes, but involve your doctor or health care team if you do run across any issues. 

4. Take regular breaks 

When things get busy at work, it can be easy to forget about taking breaks or checking on your blood sugars, but try to avoid this as much as possible. While you can of course eat at any time, I find that the days where I go off schedule (eating lunch at 2:30pm vs. 12:30pm, missing snacks, not moving from my desk for 6 hours) are the days where my blood sugars get all chaotic. Trust me, the last thing you want when you're busy at work is to be swinging from low blood sugar to high blood sugar and back. I like to set reminders on my phone when I know it’s going to be a busy day so I can keep a somewhat consistent schedule. 

5. Prepare for some bad days 

As much as I wish it weren’t the case, having diabetes means having some bad days, and those don’t stop just because you’re working. Whether it’s a rough night of sleep or just a day of high blood sugars for no reason, mentally prepare yourself that there will be days where you can’t be your best self at work. Sometimes I’ll give my manager a heads up if I think it will be noticeable or ask to work from home, but sometimes I just power through and try to be kind to myself. 

As an example, I recently had to hop on a work call after having a low blood sugar that I thought I had treated, only to embarrass myself by discovering that I was unable to recall basic words (the word I was looking for was “logo” and all I could remember to say was “a company’s picture” - haha), taking forever to respond to questions directed at me, and struggling to see my screen correctly. I realized after that I obviously hadn’t been ready for the call after the low, but there was nothing that could be done about it now. As much as it sucks, know that these things will happen and people will (...or should!) understand. 

6. Know that you will need to decide what to prioritize at times

This might fly in the face of conventional diabetes wisdom, but in my experience, there are some times where you will need to decide if you want to prioritize your diabetes/health or your career. I’m not saying this should be an ongoing decision you need to make, and of course your health is important, but I’ve also run up against a few situations where I chose to put my diabetes in the back seat, for better or worse. Here are a few examples of times when I’ve done that:

• when I needed to get something to a client by an EOD deadline and let my blood sugar continue to climb higher and higher (my site needed to be changed)

• when I went for an important walking meeting with my boss even though I knew my blood sugar would drop, and

• when I ate food someone made that I didn’t know how to bolus for on a client retreat and ended up with really high blood sugar later in the night that ruined my sleep.

  Are these things major in the long-term view of having diabetes? No. Did they suck in the moment? Yes. But ultimately, I don’t regret these decisions because they helped me advance my career and I bounced back quickly. Deciding when or if you’ll prioritize a work situation over your diabetes is an extremely personal choice and one made in the moment, but know that these situations may come up from time to time.