When a young South African pilot was diagnosed with type 1 diabetes, his dream of flying was abruptly grounded. Aviation policy at the time automatically disqualified anyone on insulin from the cockpit. Yet he refused to accept that a manageable chronic condition should end a lifelong ambition. He challenged the system, navigated years of bureaucracy and eventually won. Today, he’s back in the air, and now advocates so that others with diabetes don’t have to fight the same battle.

His victory is inspiring, but it also exposes a deeper problem. For every professional who can marshal the resources to contest unfair rules, countless others cannot.

In a mining town hundreds of kilometres away, a man living with type 2 diabetes was recently advised to start insulin to improve his glucose control. He refused, not because of fear or denial, but because company policy forbade insulin users from working underground. Taking his medication would mean losing his income. In that moment, he had to choose between health and survival, a choice no one should ever face.

These stories reveal the hidden burden of diabetes in the workplace: policies and attitudes that fail to keep pace with science, perpetuating stigma and forcing impossible decisions on people already managing a demanding condition.

Why focus on the workplace? Because the numbers tell a compelling story. More than 430 million people living with diabetes are of working age globally. About seven in 10 people with diabetes are in employment (or at an age when they could be). Meanwhile, up to three-quarters of people with diabetes have experienced anxiety, depression or another mental health condition directly because of living with diabetes. 

This dual load matters. For employees, the workplace is not just where they earn a living – it’s where they live a large part of their lives. For employers and society, it’s where productivity, inclusion and well-being converge. The official campaign theme of World Diabetes Day 2025 — ‘Diabetes and the Workplace’ – signals that the workforce is no longer a marginal setting for diabetes conversations: it’s a core site for action.

Living with diabetes requires a constant balancing act – monitoring blood glucose, planning meals, taking medication, managing fatigue and responding to unpredictable highs or lows. Now imagine doing all of that while leading a meeting, working night shifts or rushing to meet a tight deadline. The physical demands are significant; the mental and emotional load can be overwhelming.

Too often, people with diabetes feel the need to hide their condition at work to avoid judgment or discrimination. That silence comes at a cost. A workplace culture that punishes vulnerability or ignores mental health not only harms individuals – it erodes productivity, trust and well-being across the organisation.

Creating supportive workplaces is therefore not charity; it is smart public health and good business. Simple steps can transform the experience of employees living with diabetes: flexible schedules for medical appointments, providing access to healthy meals, creating designated areas for glucose testing, offering mental health support and awareness training for managers are a few examples.

To respond to this urgent gap and as part of the 2025 Diabetes Summit, the University of Pretoria, in partnership with the Diabetes Alliance, will host a dedicated pre-summit workshop titled Diabetes in the Workplace on 11 November 2025. This unique session will bring together employers, occupational health specialists, HR leaders and people living with diabetes to share experiences, identify barriers and co-create practical, evidence-informed solutions to make South African workplaces more supportive and inclusive.

As we mark World Diabetes Day on 14 November, let’s look beyond slogans. Let’s talk about empathy, flexibility and psychological safety. Let’s ensure that no one has to choose between their treatment and their livelihood, or between being open about their health and being employable. 

Because when workplaces prioritise understanding and inclusion, people with diabetes don’t just survive – they thrive. And when employees thrive, so do organisations, communities and economies.