Managing an Invisible Disability at Work

In honor of November being National Diabetes Awareness Month and November 14 being World Diabetes Day, we wanted to highlight diabetes, often considered an invisible disability, in the workplace through the lens of an Express Employment International employee with type 1 diabetes.

I look like everyone else, but I’m not like everyone else. In fact, unless my medical devices are visible, you’d think I’m just like you.

But I’m not, because I have type 1 diabetes (T1D), a chronic autoimmune disease. T1D occurs when the immune system mistakenly attacks and destroys insulin-producing cells in the pancreas—cells that are essential for survival. You can learn more about T1D here .

For more than three decades, my diabetes has been a constant presence, impacting every decision I make. It will continue to shape my choices moving forward.

When I was younger, there was a lot of focus on balancing insulin doses, food intake, and activity level. And of course, if I was ever going somewhere, was it considered a safe place based on whether the adults there understood my diabetes and could help if something happened.

These challenges and questions didn’t disappear as I grew older, they just changed as my life changed. New responsibilities emerged—stress, work, bills—which meant I needed to adjust, especially when entering the workforce.

Through my experience managing T1D in the workforce, I wanted to share my journey to help those in similar shoes but also help colleagues without T1D understand the challenges their peers face so they might be able to help.

After college it was time to find a job, and as I began to schedule interviews, I had to decide whether to disclose my diabetes during the process. There isn’t one right answer. Sometimes it felt natural to share, other times it didn’t. Sometimes my diabetes made the decision for me, as my blood sugar would drop, triggering my continuous glucose monitor (CGM) to beep. In addition to the beeping, my speech could start slurring, and my body could start sweating or even ferociously shaking.

I’ll be honest; when I have a low blood sugar, many of my external symptoms can be mistaken for intoxication. Not the impression you want to give in an interview. To manage this, I worked with my doctor to adjust my insulin levels and food consumption. If you are having the same experience, speak to your doctor, as what works for one person with T1D won’t work for the next person, and I am not a medical expert.

Every day in the office is influenced by my diabetes. Whether it’s a day full of meetings that affect lunchtime, stress from projects and deadlines, or even a fun food day, I must consider how each aspect impacts the decisions I make.

Each night before I go to bed, I review the next day’s schedule and plan. This allows me to prepare and adjust accordingly.

If lunch is impacted, I adjust as best as I can by splitting my meal or adding in a snack during the day to keep my blood sugars stable.

Stress is harder to anticipate, but working ahead on deadlines and projects helps. I have a notebook with a to-do list for each week broken into categories—must-do’s, important tasks, ongoing projects, and miscellaneous items. This keeps me on track and challenges me to think ahead.

The most important thing I’ve learned throughout my career (and even before entering the workplace) is to be prepared. T1D will never act the same two days in a row. To do this, I keep snacks (gummy bears and mini cans of regular soda) at my desk so I can quickly grab something when I notice my blood sugar dropping. I also carry a nasal glucagon and Fruit Roll-ups in my purse. No matter where I am, I have something to treat low blood sugar.

Ultimately, what has made the biggest difference is being upfront with my coworkers. Especially because I use an insulin pump and CGM and those things can beep... annoyingly! My coworkers are gracious, kind, and quick to ask if I need anything. The way they’ve adjusted and embraced having a coworker with T1D has helped me feel more comfortable about my diabetes in the workplace. With their help, I’ve realized it isn’t something to hide or be ashamed of, but rather something I’m comfortable discussing, which ultimately inspired me to share my story.