Recognizing Presymptomatic Type 1 Diabetes in the Workplace

Abstract

Occupational health clinicians often collect and/or interpret annual wellness biometrics for workers. It is now known that type 1 diabetes can present in stages including presymptomatic/normal glucose, presymptomatic/impaired glucose, and symptomatic/hyperglycemia. A workplace wellness screening case illustrates the concepts, along with background pathophysiology, recommendations for new staging and first degree relative screening, and implications for occupational health nurses.

Biometric Screenings: The Route to Occupational Safety and Health

“…Moreover, a screening event is probably the only opportunity a worker has to detect a chronic illness; that without intervention can result in a catastrophic event. For example, presymptomatic type 1 diabetes can be recognized by detecting abnormal values of hemoglobin A 1c and fasting glucose thanks to the analysis of a blood sample collected in a biometric screening event (Giese, 2018). Additionally, high levels of cholesterol, blood pressure, and obesity reveal a risk of a cardiovascular disease that can lead to a heart attack or stroke.…”

“…These screenings are defined as the process of measuring biometric characteristics such as height, weight, blood pressure, cholesterol, blood glucose, physical activity tests and more acquired at the workplace to assess the health condition of the workforce and monitor the changes throughout time(Centers for Disease Control and Prevention, 2018) Research about wellness programs and biometric screenings is predominantly healthbased (Goetzel & Ozminkowski, 2008). Regarding the employees, research focuses on health benefits such as early detection of chronic diseases (Giese, 2018) (Vanichkachorn et al, 2017), motivation into healthy behaviors (Smith, 2017), promotion of healthy lifestyles, and education (Breaux-shropshire et al, 2012) (Ryan et al, 2014). As for the company, research topics include identification of the organization's benefits such as the return of investment, cut in corporate health plans (Vanichkachorn et al, 2017) (Rameswarapu et al, 2014) (Maeng et al, 2017), ways on how to deploy effective and successful screenings via participation rate (McLellan et al, 2009) (Sherman & Addy, 2018) (Breaux-shropshire et al, 2012) and incentives (Cuellar et al, 2017) (Heathfield, 2019) (Fronstin & Roebuck, 2015).…”