By Donna MotleyVice President of Claims

The American Diabetes Association reports that as of 2015, 30.3 million Americans (9.4%) had diabetes. Of the 30.3 million Americans, only 23.1 were diagnosed, with 7.2 million Americans undiagnosed. On top of that, 84.1 million Americans (18 years or older) were considered “pre-diabetic”. As of 2015, diabetes was the 7th leading cause of death in the United States; a statistic most likely under-reported.

So what relationship does diabetes have with a work injury? Obviously, work does not “cause” diabetes. But can diabetes “cause” a work injury?

Diabetic symptoms include tingling, pain and numbness in hands and feet, known to be nerve damage and neuropathy. The diabetic with these conditions are less likely to feel pain, heat, cold. Stepping on a sharp object, working outside in extreme cold, simple finger or hand lacerations, thermal burns may go unnoticed and untreated until the condition is serious, i.e. infection.

Related to foot neuropathy, calluses can form on the feet. If not treated properly, calluses can turn into ulcers. Because of poor circulation related to diabetes, ulcers can become infected. A diabetic’s skin is usually dryer which predisposes the individual to bacterial and/or fungal infections of the skin. What is thought to be an allergic dermatitis may really be a bacterial or fungal infection.

Poor circulation slows down the healing process; the ability to fight infection is affected. Cigarette smoking would further restrict blood vessels, delaying the healing process even more. Diabetics have a higher incident rate of Carpal Tunnel Syndrome.

It is not uncommon to see skin grafting performed in diabetics that have sustained burns because the wound won’t heal. To aid in healing burns and/or grafting, hyperbaric oxygen therapy may be suggested.

Diabetics can become dehydrated more easily which can be very serious in the summer months with high temperatures inside a plant.

Low blood sugar can result in sweating, trembling, confusion, aggressiveness and seizure, which can lead to a work injury. Stress, medications and infection (such as colds or the flu) can elevate blood sugar levels.

Adhesive Capsulitis is a condition of the shoulder associated with diabetes. It involves pain and loss of the ability to move the shoulder in all directions. Dupuytren’s Contracture is a condition associated with diabetes in which the fingers and palm of the hand thicken and shorten, causing the fingers to curve inward. We have seen both of these diagnoses listed as a result of a work injury. By definition these are not work related injuries, but a medical professional will say a work injury caused the condition to rise to the surface.

Based on the above, we will ask injured workers if they have been diagnosed with diabetes, high blood pressure or any other health condition for which they treat and/or take medication on a regular basis. We don’t ask these questions in hopes of finding a reason to “deny” a claim, it is information we need to know in going forward with their medical treatment. Michigan Workers’ Compensation maintains that the employer takes the employee in whatever physical condition, with whatever predispositions and susceptibilities the employee may have prior to the injury.

Lacerations may seem “simple” enough, but you can see as outlined above, a simple laceration can turn quickly and become very costly. The statistics would indicate some of your employees are not even aware they may be diabetic, so all injuries should be reported immediately and watched closely. With diabetics, the end result of a mismanaged injury can have serious results. The earlier we are aware of an injury, the earlier we can start treatment and the earlier the employee is back to pre-injury status.