Preventing diabetes and heart disease in the workplace

Diabetes occurs when the body has trouble producing enough insulin or using it effectively. Insulin is essential so that glucose, our cells’ main source of energy, can enter cells and be transformed into energy. If there is not enough or not any insulin, blood glucose levels rise (hyperglycemia) and, in the medium and long term, there is damage to many tissues, including blood vessels, eyes, nerves, the heart and kidneys. In the most serious cases, lack of glucose inside the cells can lead to serious complications like a diabetic coma or hypoglycemic coma. Moreover, diabetes is a major cause of kidney failure, which may lead to dialysis.

There are three main types of diabetes:

• Type 1 diabetes, which results from the pancreas being unable to produce enough insulin (9% of cases)
• Type 2 diabetes, much more common (90% of diabetes cases), which either results from the pancreas not producing enough insulin or poor use of insulin (resistance) by the tissues
• Gestational diabetes (1% of all diabetes cases), diagnosed near the end of the second trimester of pregnancy, may continue (previously unrecognized diabetes) or go away after delivery

Type 1 diabetes is a genetic, auto-immune disease and there are few ways to prevent it. Type 2 diabetes, on the other hand, is most often associated with obesity and poor lifestyle habits; in other words, it is associated with modifiable factors.

Cardiovascular disease affects the heart and circulatory system. The most common cause is a buildup of cholesterol deposits (plaques) in blood vessel walls. The plaques may restrict or block blood flow to the heart or brain, causing a heart attack (myocardial infarction) or stroke (cerebrovascular accident).

Diabetes and the main types of cardiovascular disease are generally related to modifiable risk factors. Since these conditions often evolve silently at first, many people do not know they have them. Therefore, the first step towards better prevention is assessing your own risk level.

• Are you over 40? You have a one in six chance of having diabetes or prediabetes and a one in five chance of having a high bad cholesterol level.
• Do you have a family history of heart disease? Your risk of cardiovascular disease is two times higher if a member of your immediate family was diagnosed before the age of 55 in men or before menopause in women [3].
• Are you overweight or obese? Obesity is the primary risk factor for diabetes [6], while 10 kg (22 lbs) of excess weight means a 12% higher risk of developing cardiovascular disease and a 25% higher risk of having a stroke [7].
• Are you not very physically active? According to the World Health Organization (WHO), a sedentary lifestyle is a major risk factor for many chronic diseases, including cardiovascular disease, type 2 diabetes and some cancers [8].
• Do you have a poorly balanced diet? A poor diet contributes to obesity, a risk factor for diabetes and cardiovascular disease. Not eating enough fruits and vegetables is a risk factor for both diseases as well.
• Do you drink alcohol to excess? Alcoholic drinks are high in calories and contribute to obesity. Long-term alcohol abuse is often the cause of chronic pancreatitis, which frequently leads to diabetes. According to the most recent studies, there is no safe consumption level [9]! The recommendation of two drinks a day for women and three for men is no longer valid.
• Do you smoke? The risk of coronary disease goes up with the number of years of smoking and the daily number of cigarettes smoked. Even smoking fewer than five cigarettes a day increases the risk of heart disease [10]. In addition, smoking cigarettes increases the risk of developing type 2 diabetes by 30–40% [11].
• Do you have high blood pressure? High blood pressure contributes to the complications of diabetes and cardiovascular disease [12]. It is also associated with insulin resistance, thereby increasing the risk of developing type 2 diabetes. High blood pressure can cause a heart attack or stroke.
• Do you have high glucose or cholesterol levels? If so, you run the risk of developing or already having type 2 diabetes. In addition, cholesterol deposits may form in your arteries (atherosclerosis), a cause of heart disease and stroke.

Do you know your blood pressure, bad cholesterol level or glucose level? If you do not, it may be beneficial to carry out an assessment including your family history, lifestyle habits, weight and blood pressure. The assessment should also include evaluating your blood sugar level (glycemia) and cholesterol level, using a few drops of blood taken from the tip of your finger.
You can obtain all these data from an evaluation and assessment, available without a prescription.

Once your risks have been assessed, it will be easier to get motivated to address the factors you can control, such as diet, exercise, weight control, smoking cessation or reducing your alcohol consumption. These measures, tailored to your situation, can be consolidated with treatments prescribed by a healthcare specialist.

It is estimated that approximately 10% of Canadians have diabetes and 6% have prediabetes, a condition which increases the risk of developing type 2 diabetes. About 40% of people diagnosed with type 2 diabetes are under 65, the usual retirement age. In other words, nearly one worker in 20 has prediabetes or type 2 diabetes [1].

In Canada, over 8% of the population have been diagnosed with cardiovascular disease. Twenty per cent of people aged 40–59 have an unhealthy cholesterol level and one quarter of them do not even know [12]. As well, diabetics face a 4-times higher risk of developing cardiovascular disease [13].

For employers, the costs of both these chronic diseases are very high [2].

• Cardiovascular disease is one of the five main conditions for workplace disability.
• Heart disease and strokes are the main reasons for using prescription drugs.
• Diabetic employees miss 2–10 more days a year than their non-diabetic colleagues.
• Diabetes alone makes up 8.5% of Sun Life insurance claims.

Those data do not include costs associated with absenteeism, presenteeism (reduced productivity), loss of expertise when replacing experienced employees, and more.

Diabetes and the main forms of cardiovascular disease can be attributed to modifiable factors. As a result, employers can intervene to make their workers aware of the risks of developing these chronic diseases, so as to prevent and control them.

Expand your workplace health and wellness program with workshops and training sessions. The Biron Health at Work team can support you by organizing activities to suit your needs.

Even though there is a lot of information available, many workers (and managers) do not know much about diabetes or cardiovascular disease. Educating yourself and educating staff about the risk factors and complications of both these conditions is the foundation for building awareness. Information is easy to find, including from the Canadian Diabetes Association.

One of the most effective awareness-building techniques is screening: knowing you are at high risk of developing diabetes or cardiovascular disease is a powerful awareness-raising tool. There are steps that can be taken at work, such as questionnaires about family history and lifestyle habits, measuring weight or blood pressure, and then complementing those by blood sugar or cholesterol tests using a drop of blood from the tip of your finger (redirecting to Biron Health at Work’s Express and Elite check-ups).

Prevention and support are often based on the same principles: learning about, developing and maintaining good lifestyle habits, such as:

• raising awareness about the specific problems of smoking and excessive alcohol consumption
• promoting staff exercise programs;
• making sure that healthy foods are available in the cafeteria or vending machines;
• arranging schedules which reconcile work responsibilities with medical care.

In this time when there is a lack of skilled labour, it is increasingly obvious that employers who want to retain employees need to play an active role in preventing both these diseases. There are easy actions to take in the workplace. Preventing diabetes and cardiovascular disease is not only beneficial for employee health, but also for the company’s bottom line!

This revised edition reflects an updated version from the original version published on our website. We have incorporated recent facts to offer you current and pertinent information.