Non-disclosure of type 2 diabetes at work among Danish employees

Background and aims: Increasing retirement age in many OECD countries, in addition to increasing prevalence of type 2 diabetes in younger people, is expected to result in a substantial increase of people with type 2 diabetes in the labour force. In many jobs, disclosure of diabetes at the work place is necessary for optimal self-management during work hours, whereas non-disclosure may lead to impaired self-management behaviours, such as adverse eating, inexpedient consumption of medication, or not taking necessary breaks. We explored which factors were associated with disclosing diabetes at work among Danish workers with type 2 diabetes.

Materials and methods: In total 705 people with type 2 diabetes successfully completed a questionnaire including work and diabetes related questions. Three logistic regressions were modelled to estimate the associations between the included factors and likelihood of disclosure to employer and colleagues. Associations were expressed by odds ratios and 95% confidence intervals. The models were adjusted for background characteristics, socio-economic factors, life-style factors, diabetes duration, diabetes treatment, and work-related factors.

Results: Almost a quarter of the participants (23%) had not disclosed their diabetes to employer and colleagues, whilst (13%) of the participants had not disclosed their diabetes to at least one colleague. In the adjusted logistic regression analysis, workers with, long diabetes duration, and use of diabetes medication, particular injections, were more likely to disclose their diabetes to their employer. People who reported receiving respect from their superiors were also more likely to disclose their diabetes. Likewise, participants who considered it an employer responsibility to provide flexible work conditions for people with chronic illness were more likely to disclose their diabetes. In contrast, people with the highest educational level were less likely to disclose their diabetes. Adjustment for covariates in the analyses slightly modified the estimates.

Conclusion: Workplace factors rather than individual factors seemed associated with disclosure. Future prospective studies should focus on reasons for concealing type 2 diabetes at work and impact of disclosure on diabetes self-management and work environment.