Reasonable adjustments for diabetes: 10 real examples
If an employee's diabetes counts as a disability, you have a legal duty to make reasonable adjustments. That sounds expensive. In practice, most adjustments for diabetes cost nothing at all. They're about time, flexibility and a bit of common sense.
Here are ten real examples, and how to agree them properly.
What makes an adjustment reasonable?
The law doesn't give a fixed list. It depends on things like how much difference the change would make, how practical it is, what it would cost and the size of your organisation. A change that's easy for a large company might not be reasonable for a business of five people, and the other way round.
The best way to find out what someone needs is simple. Ask them.
10 real examples
1. Regular breaks to eat or test. Someone on insulin or certain tablets may need to eat at set times. Fixed break times, or the freedom to take a short break when needed, is the most common adjustment of all.
2. Somewhere private to test or inject. A clean, private space. Not a toilet.
3. Somewhere to keep insulin. A shelf in a staff fridge is usually enough.
4. Snacks and hypo treatment at their workstation. Even if food is normally banned in that area. Being able to treat a hypo quickly matters.
5. Their phone within reach. Many people now use a sensor on their arm that sends readings to their phone. If phones are banned on the shop floor or in meetings, an exception may be needed.
6. Time off for appointments. Diabetes means regular clinic visits, eye screening, foot checks and sometimes a free NHS course like DESMOND. Allowing time off for these, paid or unpaid, is a common adjustment.
7. Adjusting absence triggers. Recording diabetes-related absence separately, or raising the trigger points in your absence policy for that person. This matters most if you use a scoring system like the Bradford Factor, which punishes short, frequent absences.
8. Flexible start times. A bad night of blood sugar can make mornings hard. A little flexibility can make a big difference.
9. Changes to shift patterns. Rotating shifts and nights can make diabetes much harder to manage. Moving someone to fixed shifts, or reducing nights, may be reasonable. I've covered this in Night shifts and diabetes.
10. Temporary changes to targets or duties. When someone's treatment changes, for example starting insulin, they may need a few weeks of lighter duties or adjusted targets while they settle.
How to agree adjustments
- Have a private conversation. Ask what would help. Don't guess.
- Look at the job. A diabetes risk assessment often shows which adjustments are needed.
- Get advice if you need it. Occupational health can help if you have it. There's also a government scheme called Access to Work that can help pay for support. Check gov.uk.
- Write it down. Record what was agreed, who needs to know and when you'll review it. An adjustment agreement signed by both of you is the best paper trail you can have.
- Review it. Diabetes changes over time, and so do jobs.
Can you say no?
You can refuse an adjustment if it genuinely isn't reasonable, but you need a good reason and you should be able to explain it. Cost alone is rarely enough for small, simple changes. If you do say no, look at whether there's something else that would help instead, and write down how you reached your decision.
Start here
My free 7-day plan takes you through the first week after someone tells you they have diabetes, and includes a ready-to-use adjustment agreement. For the full set of forms, policies and manager guides, see the Diabetes at Work Kit.
For the legal background, read Type 2 diabetes at work: the law in the UK.
This is general information, not legal advice. For a specific case, speak to an employment lawyer or Acas.
Get the free 7-day plan
For managers and HR. It walks you through the first week after someone tells you they have diabetes, with the forms you need, ready to print.
Send me the free plan
Want your whole organisation covered? See the Diabetes at Work Kit: 42 documents, £495.
Questions people ask
What counts as a reasonable adjustment for diabetes?
Common examples are regular breaks to eat or test, a private place to inject, somewhere to keep insulin, time off for appointments, flexible start times and adjusting absence triggers. Most cost nothing.
Should diabetes-related absence count towards the Bradford Factor?
Counting it in the same way as other sickness can be discriminatory. Many employers record diabetes-related absence separately or adjust the trigger points for that employee as a reasonable adjustment.
Does the employee have to ask for reasonable adjustments?
No. Once you know, or could reasonably be expected to know, that someone is disabled, you should think about adjustments yourself. In practice the best adjustments come from asking the employee what would help.
Keep reading
Auriel isn't a doctor or a lawyer. This is general information from her own experience and UK guidance. Always follow your GP and diabetes team.