Employer’s Guide to Type 1


Editor’s Note: This content is a part of Beyond Type 1’s guidebook, which includes guides for everyone who has a type 1 in their life. Check out the rest of our customized guides for the different people in your life here!

Get Informed

You may or may not have a general idea about type 1 diabetes. Clear your assumptions and check out our basic guides on what exactly type 1 diabetes (T1D) is. This knowledge will help you to better understand your employee’s needs. Type 1 diabetes can affect an individual in many different ways, so be sure to keep the line of communication open with your employee.

What is Type 1 diabetes?

Type 1 diabetes is an autoimmune disease that occurs when a person’s own immune system destroys the insulin-producing cells in their pancreas. People with type 1 are insulin-dependent for life, and must manually give themselves insulin through multiple daily injections or an insulin pump. They must carefully balance insulin, food, exercise and other factors in order to prevent or minimize serious short and long-term complications due to out of range blood sugar levels.

If you have not heard much about type 1, here are some fast facts— 

  • Type 1 diabetes (T1D) is not caused by a lack of exercise or eating too much sugar.
  • T1D is not contagious.
  • There is no cure for T1D at the present moment.
  • Although T1D has also been called “juvenile diabetes,” T1D affects both children and adults.

You should be aware of hypoglycemiahyperglycemia and other emergency situations. It’s best to ask your employee to establish protocols for an emergency type situation.

Emergency scenario

If we are ever passed out or unconscious, immediately call emergency services and react to the situation as if we were “having a low” or experiencing severe hypoglycemia. If we are unconscious, you may have to administer emergency glucagon.

If we are conscious, fast-acting glucose needs to be taken immediately. This means juice boxes, candy, glucose tablets, or any other sugary food or drink that can be consumed easily.


T1D is considered a disability, and is protected under United States law. Therefore, you cannot discriminate against your employee for their type 1 by any of the following:

  • fail to hire or promote an employee because of type 1
  • terminate someone because of type 1, unless they pose a direct threat
  • discriminate with regard to employer-provided health insurance

Make Reasonable Accommodations

If an applicant voluntarily tells you that he or she has diabetes, you only may ask two questions: whether he or she needs reasonable accommodations and what type of accommodation. You are also required to provide your employee with these reasonable accommodations that will help them perform the essential functions of the job.  Generally, accommodations for those with type 1 are easy, inexpensive and helpful. This is another conversation that is helpful to have with your employee to make sure that you understand the circumstances.

Reasonable accommodations can include:

  • Daily diabetes management needs, (such as managing blood sugar levels)
  • Taking the necessary insulin
  • Treating any hypoglycemic or hyperglycemic episodes

Medical Leave

Your T1D employee has a right to take medical leave due to any T1D complications. The Family and Medical Leave Act requires most private employers with over 50 employees and most government employers to provide up to 12 weeks of leave per year because of the worker’s, or an immediate family member’s serious health condition.

This leave can be flexible. For example, you can split up the leave into small blocks of time to deal with short-term problems such as managing blood glucose levels or doctor’s appointments.

Employer’s Rights

As the employer, you do have certain rights to protect yourself. If you have a legitimate reason to believe that diabetes may be affecting an employee’s ability to do their job, you may ask questions or require the employee to have a medical examination.

These situations are generally limited to employment physicals, requests for reasonable accommodation, when the employee return from work following an extended medical leave, or when you have experienced a medical problem on the job that raises safety issues for you.

To avoid any charges of diabetes discrimination, let your employee know if you feel that his or her actions cause a safety risk to other employees. In general, T1Ds can be safe, responsible and effective workers regardless of what they are living with. It is important to realize that emergency situations can and will occur, sometimes because of uncontrollable causes. If you are unsure of how to handle situations or feel overwhelmed with how to handle emergencies, speak to your employee.

The Laws That Protect T1Ds

There are laws that protect your employee. Both federal and state laws in the U.S. offer protection from workplace discrimination.

  • The Americans with Disabilities Act applies to private employers, labor unions, and employment agencies with 15 or more employees, and to state and local government.
  • The Rehabilitation Act of 1973 generally covers employees who work for the executive branch of the federal government, or for any employer that receives federal money.
  • The Congressional Accountability Act covers employees of Congress and most legislative branch agencies.
  • All states have their own anti-discrimination laws and agencies responsible for enforcing those laws. Some state anti-discrimination laws provide more comprehensive protection than do the federal laws.

See the rest of our customized guides here.

WRITTEN BY BT1 Editorial Team, POSTED 12/23/16, UPDATED 12/26/22

This piece was authored collaboratively by the Beyond Type 1 Editorial Team.