Perceived stigma prompts workers to conceal type 1 diabetes from colleagues
medwireNews: The fear of work colleagues making too much or too little of a type 1 diabetes diagnosis causes many patients to conceal their condition, shows a study of Finnish workers.
“Although [type 1 diabetes] is not necessarily considered a very stigmatising condition by the general public, people with the condition nevertheless feel stigmatised by it,” observe Pirjo Hakkarainen (University of Eastern Finland, Kuopio) and co-researchers.
The team surveyed 688 working age people with type 1 diabetes, aged an average of 36 years old, of whom 47% were women and 44% had been living with diabetes for more than 10 years. Of these, 30% had, at some point in their career, concealed their diabetes from their work colleagues, 18% had done so from their line manager, and 16% had concealed it from both.
“This is noteworthy, because colleagues may be the first ones to notice a hypoglycaemia event and to offer help when needed,” write the researchers in BMJ Open.
“In addition, the line manager can support a worker with [type 1 diabetes] to manage their condition effectively at work if they knew about a worker’s [type 1 diabetes] status.”
Concealment of diabetes was significantly more likely with younger age, and was also associated with revealing the diagnosis only to closest family, feeling an outsider at work, being embarrassed by the idea of receiving special attention, and neglecting glycemic management while at work.
The nondisclosure of diabetes by young people “may be especially harmful for their health as they have a long working life ahead of them,” says the team, suggesting that support should be particularly focused on this age group.
The team then conducted interviews with 20 of the survey respondents who had admitted to concealing their diabetes, which identified five main categories of reason for concealment. Four of these were a reaction to the anticipated behaviors of colleagues: being seen as weak; being discriminated against at work; receiving unwanted attention; and being suspected of using diabetes to gain advantage.
Specific examples given by the patients included the fear of being passed over for promotion, of colleagues being overprotective or patronizing, or, conversely, of being hostile to patients’ need for regular meal breaks.
The fifth category related to loss of privacy, with patients feeling their diabetes was a private matter that they only felt comfortable discussing with close family and friends.
“When asked in what kind of workplace disclosing one’s illness would be easy, the interviewees emphasised openness, trust and mutual caring of each other as important factors favouring [disclosure],” say the researchers.
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