Impact of the work environment on glycemic control and adaptation to diabetes

OBJECTIVE - To evaluate quantitatively whether the work environments of adu lts with diabetes relate to the adequacy of metabolic control and/or to the individual's adaptation to diabetes and to explore qualitatively the inter actions between an individual's life at work and ways of coping with diabet es. RESEARCH DESIGN AND METHODS - A total of 129 insulin-requiring adults who w ere employed outside of the home were assessed on a single occasion. They c ompleted two work system measures (The Work Environment Scale and The Work Apgar Scale) and two quality-of-life measures (The Diabetes Quality of Life Scale and The Appraisal of Diabetes Scale). Subjects also participated in a semi structured interview concerning the interaction of work and diabetes . Glycemic control was assessed by using HbA(1c) results. Demographic data (age, sex, diabetes type, duration of diabetes, number of diabetes-related medical complications) were gathered from the charts. RESULTS - Concerning glycemic control, neither of the work system measures was a significant predictor of HbA(1c). Concerning psychosocial adaptation, supervisor support was found to be a significant predictor of positive app raisal and diabetes-related satisfaction. Involvement and coworker cohesion also predicted aspects of diabetes-related quality of life. Interview them es showed that for a minority (18%), diabetes affected choice of work and t hat for a majority (60%), diabetes affected relationships at work and raise d financial/job concerns (49%). Most adjust their diet, blood glucose testi ng, and exercise regimen through work-related modifications. CONCLUSIONS - For insulin-treated adults with diabetes, work system variabl es do not directly relate to glycemic control, bur they do relate to psycho social adaptation Future work should examine further the specific aspects o f the workplace that might affect adaptation, with the goal being to develo p worksite interventions that target not only the employee with diabetes bu r also their supervisors and coworkers.