When television's perennially popular Mary Richards walked into WJM's Minneapolis newsroom in 1970, she did more than show the world a single girl could "make it on her own." The award-winning actress who portrayed her -- Mary Tyler Moore -- also showed us diabetes and a career could coexist.
Moore was diagnosed with adult-onset type 1 diabetes in the 1960s, several years before her Emmy-winning show began. But that didn't stop Moore from pursuing her career or turning the world on with a smile.
"I made a decision early in my life to find a career where diabetes and success could coexist," says Paul Strumph, MD. Strumph is chief medical officer of the Juvenile Diabetes Research Foundation. He also has type 1 diabetes. "I don't wear it like a badge," he says. "But clearly my career has not suffered because of my diabetes."
The same is true for San Diego resident Aaron Synder. Synder was diagnosed with type 2 diabetes when he was 20. Today, at age 30, he's a successful trader. "I have a job that requires me to be at work before 5:30 a.m., and I sometimes stay until 5:30 p.m.," Synder says. "I'm continuously surrounded by free candy, sodas, and chips on a daily basis. But I still manage to keep my blood sugar under control and not let my illness interfere with my job." In addition to his job, Synder, is a patient counselor and is also writing a book to help other people with diabetes gain control of their life and career.
It isn't always easy to do what Synder and Strumph do. Both agree that having diabetes does present some workday challenges. But, says endocrinologist Lauren Golden, MD, knowledge is the key that can turn obstacles into opportunities.
"The more you know about your diabetes," Golden says, "and the more you know about controlling your blood sugars, the better off you'll be." Golden is a diabetes specialist at the Naomi Berrie Diabetes Center at Columbia Presbyterian Medical Center in New York City. She tells WebMD that the more you know, the better prepared you will be to deal with any work situations that arise, "including explaining your condition to others if you need to."
To help you put your best work-foot forward, WebMD asked a panel of patients and experts for tips and advice about controlling diabetes in the work place. What they said can help you gain control not just of diabetes, but of your occupation as well.
Diabetes on the Job: Start Your Workday Right
Everyone is strapped for time in the morning. But, nutritionist Samantha Heller, MS, RD, CDN, says, never skip breakfast, particularly on a workday. Heller is a dietitian and nutrition adviser for JourneyForControl.com, a diabetes education site. "When you have diabetes," Heller says, "especially if you are on medication, skipping breakfast can lead to dangerously low sugar levels." That, she points out, can not only affect your health, but also your safety. "Often," she tells WebMD, "it can have an impact on your job performance too."
Heller says a healthy breakfast of fat-free yogurt, some whole-grain cereal, an egg white omelet, or even a whole-wheat bagel with cream cheese will help set the tone for a productive workday. It's also important, she says, to have a workday "meal plan" in mind -- one that can help keep energy levels and concentration high throughout the day.
One way to do that is to bring your lunch and snacks from home. That way, you know exactly what you're going to be eating. In addition, if you take insulin, Golden says you should have food ready to eat following your injection. Doing so can prevent low blood sugar problems that may occur when there is too much time between your injection and your meal.
If brown-bagging it is not convenient or possible, Golden says it's important to familiarize yourself with whatever foods are going to be available to you. Whether the food comes from a lunch cart, cafeteria, or diner, Golden says there will always be some choices that are better than others. "I urge my patients," she says, "to learn what's in the dishes they think they might like."
That means taking a trip to the cafeteria ahead of time and asking lots of questions. Ditto for the lunch cart caterer or the local eatery. "Don't feel embarrassed to ask," Golden says. "You have to figure out what's best for you from both a blood sugar and a calorie perspective."
If you don't want to reveal you're asking because you have diabetes, experts say you can always fall back on allergies or even weight control as your reason for the inquiry. Experts also recommend compiling a list of "safe foods" that you know are going to be OK to eat no matter where or when you eat them.
Diabetes on the Job: Testing Sugar Levels and Taking Insulin
At some point, you're going to need to test your blood sugar while you're on the job. Experts say a little planning can make it easier to fit doing so into your workday.
"What concerns many employers and other employees," Golden says, "is the blood and the instruments used to draw the blood. But if you prepare a discreet kit ahead of time, with a clean, neat way of disposing your lancets, there shouldn't be a problem."
She says an empty milk carton makes a great disposal system. You can keep it in a desk drawer along with a package of individually wrapped alcohol prep pads to wipe your finger before testing and to help insure both an accurate test and easy cleanup.
Sometimes it's impossible to get a minute of privacy at your desk to take your test. Then, says Golden, keeping all your supplies in a small bag makes it easier to sneak in a quick trip to the restroom. "Having everything together," she says, "will allow you to slip out and back in very quickly. Being organized is the best way to be discreet."
It may seem that using insulin on the job would be an even more difficult task. But Randall J. Urban, MD, director of the Stark Diabetes Center at the University of Texas Medical Branch, says it's not true. "The new insulin pens don't need refrigeration," Urban says. "And they can be used pretty much anywhere, very discreetly. You just need to take some time to practice."
What can also help, he says, is the new long-acting insulin. Long-acting insulin can minimize the number of injections you need over the course of a day. "This has been a fantastic advance for diabetes patients," he says. "So if you're currently not using a long acting insulin you should speak to your doctor about whether it's right for you. It can make managing diabetes in the workplace much, much easier."
If you must refrigerate your insulin and either don't have access to a refrigerator or don't want co-workers to know, products like the IceyBag can help keep your medicine cold throughout an entire day. It features a small, refreezable insert that fits in the bottom of a cooler bag, and it will stay cold for up to eight hours.
Diabetes on the Job: To tell or Not to Tell
One of the biggest work issues faced by people with diabetes is whether or not to tell the boss, or even co-workers, about their disease. Either way, it's important to know that the Americans With Disabilities Act (ADA) prohibits potential employers from asking if you have type 1 diabetes or asking questions concerning insulin use or other prescription drugs.
Once you have the job, however, the decision is yours as to whether or not to keep it personal or let others know. That said, experts believe it is important that at least one person in your workplace know of your condition, particularly if you are using insulin. That person could be a co-worker, nurse, or supervisor.
"You should tell someone who is physically near you at work that you have diabetes," says Strumph, "particularly if you take insulin. Give them a description of what happens when blood sugars drop too low. And tell them the basic emergency treatment for this."
Moreover, he says, always have glucagon with you -- either in your desk or on you. And make certain that someone at work knows how to give it to you in the event of an emergency. Glucagon is an injectable medicine that can raise blood sugar in an emergency.
Synder agrees. "You have to treat low blood sugar swiftly. If you teach your co-workers about that, it can not only save your life in an emergency, but also help them to better understand your behavior if and when your sugar goes low." Synder tells WebMD that if your sugar goes low, you can become cranky or even prone to emotional outbursts.
If you're having problems judging when your sugar levels are dropping, talk to your doctor about continuous glucose monitoring (CGM) watches. CGM watches sound an alarm when glucose drops below a certain level.
But even if a trusted colleague knows your condition, should you still tell the boss? What if you think that it might have an impact on whether you move ahead in your job? According to Rosalind Joffee, president of cicoach.com, an online resource for professionals with chronic illness, telling should always begin on a "need to know" basis. But if you do decide to tell, don't assume that simply saying, "I have diabetes" is all you need to do.
Joffee says you need to always be prepared to explain how your condition might affect your work life -- and have answers about how you're going to handle that.
"The key points to keep in mind when deciding to talk to your boss," Joffee says, "are, first, what outcomes are you looking for in the conversation? What do you need from your workplace to help you get your job done so that diabetes does not stop you? Finally, what ideas do you have for how this can happen?"
The point, she says, is to go into the conversation with a positive can-do attitude. It's also important to have solutions ready for any problems you are encountering and need to discuss. For example, how can you get a midmorning snack or take a quick break to test your blood sugar or administer an insulin injection?
Here, knowledge of your disease is important. Golden says the better you know your disease, "The easier it will be to know what you need to succeed at work. Also, the easier it will be to convey your needs to others. "
Diabetes on the Job: 7 More at-Work Tips
Here are seven more suggestions from the experts about how you can make it easier to control your diabetes at work.
1. "Do not be embarrassed if you need to eat something at a meeting -- just do it," says Strumph. Moreover, he says, always carry some glucose-rich food in your clothing or within arms reach and eat it when you need it. Hard candies are a meeting-friendly glucose booster.
2. If it's just too embarrassing to pull out a snack at a board meeting or client presentation, simply excuse yourself for a bathroom break, Golden says, and start munching the minute you're out the door.
3. Always explain any limitations realistically to your manager. Strumph says if the organization can't work with you, it's better to find out sooner than later.
4. Get enough sleep, says Synder. "Aside from poor food choices," he says, "stress has the next greatest negative impact on your blood sugar. Lack of sleep is the greatest stress. So make sure you get enough."
5. Be sure to stay well hydrated throughout the day, says Heller. "Sometimes we confuse hunger with thirst. So make sure you know your symptoms."
6. When that office birthday party or holiday celebration rolls around, you can almost always participate by taking just a small sliver of cake, says Heller. If no one knows you have diabetes, you can still keep your secret.
7. Keep "stress foods" on hand -- healthy snacks that can help control your blood sugar during highly stressful workdays and keep your emotions on track. Synder suggests nuts, protein bars, and nutrition shakes, which, he says, are all portable, can be quickly eaten, and won't spoil when kept in a desk drawer or even a locker.