Do the Interactions Between Type 1 Diabetes and Work Support Self-Management? A Best-Evidence Synthesis.

Work can be challenging for people with Type 1 diabetes, in part due to difficulties around workplace self-management. What is unclear is the level of accommodation needed, and the type of support required, for effective self-management. To understand the interactions between work and Type 1 diabetes, a best-evidence synthesis of the available grey and peer-reviewed literature was conducted. Twenty-eight articles were included for thematic analysis. Three themes were formulated: (1) How work can be challenging for people with T1D, (2) how work can be beneficial for people with T1D, and (3) influence of policy and legislation. The interactions between Type 1 diabetes and work can hinder self-management. Work-related diabetes distress, concealment, stigma, lack of action space, and work-related intentional hyperglycaemia were reported concerns. Legislation and workplace policy around sickness and disability seem to be relatively inflexible and do not readily accommodate the needs of people with Type 1 diabetes. Conversely, work has acknowledged benefits for health and well-being, indicating a need to facilitate workplace accommodation for people with Type 1 diabetes. Current workplaces do not provide optimal support and accommodation for self-management of Type 1 diabetes. Future research should explore interventions that engage workers in their diabetes management, emphasising individual differences and empowerment. Moving forward, fostering collaborative approaches between the key actors, including managers, human resources, occupational health, and workers with Type 1 diabetes, could be important.