Your responsibilities as an employer: Staff with diabetes

Nearly four million people are living with diabetes, which can be catastrophic without the right support.

Picture this. You run a busy high street hair salon employing 10 staff. Your senior stylist has type one diabetes and requires multiple daily insulin injections. One day, your receptionist inadvertently pricks himself on one of the stylist's discarded needles. All hell breaks loose.

Most insulin pens use needles that are only 4mm, so the pain doesn't last as long as the worry. A Google search reveals the risks: blood borne pathogens such as hepatitis c or HIV. Your horrified staff blame you. There was nowhere to safely dispose of needles at the salon.

Are employers legally required to provide sharps bins for diabetic staff?

It's a grey area. Of course, all employers are legally required to provide a safe working environment for staff. That's why you carry out risk assessments and provide sanitary bins in the toilets and sealed containers for used razors at your stylists' stations.

But there is no law that explicitly states employers of diabetic staff must provide safe means of disposal of needles at work. The 2013 Health & Safety Regulations only name healthcare providers and contractors in its guidance on sharps regulations in the workplace.

That doesn't clear you. The Equality Act 2010 requires employers to make 'reasonable adjustments' to accommodate disabled staff. Few view diabetes as a disability, but it has a 'substantial and long-term negative effect' on sufferers, so the act defines it as such.

You knew your stylist had type one diabetes and understood she needs regular injections. You had the resources to provide a sharps bin and doing so wouldn't have been excessively disruptive, so under the act it would be a 'reasonable' adjustment.

Why do employers need to know about diabetes?

If you employ 20 people, the chances are you have a diabetic in your team.

There are 3.7 million people in the UK living with diabetes and 90% of these have type two, a condition usually linked to old age or lifestyle that can ordinarily be controlled through diet and exercise but in extreme cases requires multiple daily insulin injections.

The other 10% have type one, an autoimmune condition that renders the pancreas totally unable to produce insulin (type twos usually produce some), a hormone  that aids the conversion of sugar into energy in the body. It means lifelong insulin injections and regular medical checks but needn't cut lives short.

So long as it's well managed, at home and at work, that is.

Charity Diabetes UK advises that anyone living with either type of diabetes makes it clear to employers that they have the condition and what it entails, once they have received a formal job offer.

The Equality Act makes it unlawful to enquire about a candidate's health in the recruitment process (in most cases), so once a job has been offered (and only then), employers need to determine if staff have any health conditions that require adjustments to the workplace.

Just as no one can expect you, the employer, to adjust for a condition you're unaware anyone has, it's not reasonable to expect you to become an expert in diabetes overnight. "A simple explanation about diabetes is all you need to give," is the advice Diabetes UK gives diabetic employees.

What can employers do to help staff with diabetes?

Diabetes is serious. If poorly managed or left undiagnosed (look for excessive thirst, weight loss, tiredness, or a constant need to urinate), both types can have a catastrophic impact on the health of anyone who has the condition.

Hypoglycaemia can become a part of life for type one diabetics. A 'hypo' happens when blood sugar levels drop too low after taking too much insulin or not eating enough.

Most often a diabetic will spot the symptoms (tingling lips, drifting thoughts, glazed eyes) and self treat. Extreme cases can be characterised by deliriousness, fitting and unconsciousness.

They can be alarming to witness but can usually be treated quickly and effectively with glucose. If this does not rouse a diabetic from a hypo, paramedics should be called. Diabetes UK recommends that diabetic employees tell colleagues what to do if a hypo hits.

A reasonable adjustment (remember, 'reasonable' is the key test of the Equality Act) would be to keep something sugary in the workplace and remain mindful of the risk of hypos and the opposite, hyperglycaemia (when blood sugar levels get too high).

Diabetics need to regularly test their blood sugar level, usually by pricking their fingers. Too low, take sugar; too high, inject insulin (usually). High blood sugar can cause a dangerous condition called ketoacidosis. Look for nausea, abdominal pain or fruity smelling breath.

Everyone needs to visit the doctor from time to time, but most diabetics require more contact. Again, employers must make reasonable adjustments for this. It's also reasonable, says Diabetes UK, for employers to expect reasonable notice about medical appointments.

The requirement for being reasonable goes both ways.