QIf you learned a new member of your team suffered from diabetes would you know what to expect, or how to help? Would you even be sure of exactly what the disease entails?

Given diabetes is rapidly on the rise in this country, as elsewhere, we asked Marguerite for information about the disease and advice on how organisations and their managers can support staff members who suffer from it.

A.Marguerite writes:

Many of you will have heard about the 'diabetes epidemic' but too often little is known of this invisible killer. Diabetes is emerging fast as the biggest health catastrophe the world has ever seen.

Diabetes in brief

Diabetes is a condition in which the body cannot easily convert food into energy. This is because the body either cannot produce the hormone insulin or the insulin is not working effectively in the body. The resulting high blood glucose levels eventually damage both the large blood vessels of the heart, brain and legs and the tiny capillaries supplying the eyes, kidneys and nerves. Typical complications of diabetes are serious and need ongoing management.

What's driving the rise in diabetes? Lifestyle factors play a large role: the increasingly fast pace of modern life means people now consume more energy-dense convenience foods with ever fewer opportunities to burn off those extra calories.

The main types of diabetes are described here.

An epidemic

In this country nineteen people are diagnosed with diabetes every day and the incidence of diabetes across all ethnic groups is forecast to double to half a million over the next 15 years. Most new cases will come in Type 2 diabetes. Particularly hard hit are Maori, Pacific and Asian peoples with twice the prevalence of Europeans. Despite these alarming figures, little concerted effort has been put into tackling the health issue that will affect more New Zealanders than any other.

Costs

Comprehensive prevention programmes aren't easy, but the cost of doing nothing is far greater in terms of lost productivity and the tax dollars that will have to be spent managing diabetes' impact. Over half of all heart attacks and strokes can be attributed to diabetes as can over 60% of the cases of renal failure and blindness in New Zealand.

By 2020, the cost of diabetes-related care will have risen to 14% of the public health budget in this country. That's more than one billion dollars extra every year.

What does this mean for employers?

Much of the daily burden will fall squarely on the shoulders of employers. Managers should expect marked increases in sick days, either taken by the employee personally or taken to care for family members with diabetes complications. There will also be many more cases of reduced efficiency or suboptimal performance as the result of impaired functioning from undiagnosed diabetes.

All this implies heavy penalties to companies in terms of lost productivity and output.

What can employers do in general?

Against this depressing backdrop of illness, company Health and Safety policies will be under much greater scrutiny. Employers would be well-advised to raise their workforce's awareness of the whole diabetes picture and to start:

• Offering choices for improved employee nutrition in the cafeteria. Foods that are appropriate for people with diabetes are normal and healthy for all staff. Vegetables, fruit, whole grains, legumes, low fat dairy foods and lean meats are the most important.
• Developing opportunities for regular physical activity. Activity helps glucose control and reduces blood pressure. It keeps weight down as well as making those with diabetes feel better.

How can employers support staff suffering from diabetes?

People with diabetes are well used to self-managing their own condition and most days you will not notice any problem. However, it is wise to ensure they:

• take their designated breaks on time
• not skip meals.

Dealing with a "Hypo"

It is possible a staff member may suffer a "hypo" - a hypoglycaemic attack - that occurs when blood glucose falls below the normal level.

There are several warning signs that a person with diabetes will recognise as the onset of a hypo. They include feeling dizzy, faint or sweating. However, some people lose the ability to recognise these warnings. Your employee may then become moody, irritable or irrational, confused, unable to concentrate and may start shaking.

Treatment is by giving some form of fast-acting sugar, like glucose tablets or a few jelly beans, which raise the blood glucose levels rapidly. This needs to be followed by a sandwich or meal to ensure the level doesn't drop again.

If the symptoms are ignored, the blood glucose may continue to fall so far that the brain is starved of glucose. The employee may eventually lose consciousness. If this happens:

• Do not give anything by mouth if the person is unconscious.
• Lay the person on his or her side and dial 111 for an ambulance.

Is it easy to tell if someone has Type 2 diabetes?

Unfortunately, no. Frequently there are no symptoms. A recent study found that, on average, people newly diagnosed with Type 2 diabetes have had it for 9-12 years. Half were already developing complications by the time they were diagnosed. It is this unmanaged diabetes which fosters the development of severe complications.

Where symptoms do show, constant unexplained thirst is one symptom that requires further investigation. Other symptoms can include blurred vision, unexplained tiredness, passing urine more frequently, wounds that don't heal and recurring infections.

However, these symptoms often get misdiagnosed (i.e. more frequent urination is attributed to advancing years) or can indicate some other problem so it is always wise to have them assessed by a doctor.

Remember that people of all ages can develop diabetes. With rising levels of obesity, more and more young people are contracting Type 2 diabetes - even children.

To learn more

Take advantage of opportunities for education and support from your company GP or local diabetes society. Diabetes NZ Auckland offers a simple Risk Assessment. You can encourage staff to click on 'Take the Test' to check out their own risk.

People who do take control of their diabetes can play their part in society to the fullest extent, and they perform in every walk of life!

Acknowledgement

Marguerite Durling is the Assistant General Manager for Diabetes NZ Auckland, which is the local society for the greater Auckland region.

Diabetes NZ Auckland offer Prevention and Awareness programmes in the workplace in addition to six-part "Healthy Living with Diabetes" courses that will support people in managing diabetes well. Phone Diabetes NZ Auckland on 09 623 2508 for information on courses or visit their website to see the full range of services they offer.

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