Understanding Barriers and Facilitators to Sustained Work Participation for Individuals with Diabetes Through an Intersectional Lens: a Qualitative Study

Abstract Purpose Diabetes is a chronic condition that affects many aspects of individuals’ lives, including their ability to participate in work and daily activities. However, how diabetes affects the (work) participation of women and men of different backgrounds, remains unclear. Methods We conducted 12 interviews with women and men with diabetes of different ethnic and socioeconomic backgrounds between the ages of 18 and 67. These interviews concerned participants’ characteristics, as well as work-related and social factors that affected their ability to continue paid work with diabetes. We used outcome-mapping to facilitate the discussion of different factors affecting (work) participation with diabetes. We conducted a thematic analysis using an interpretative research paradigm and an exploratory secondary intersectional analysis, and structured our results using the International Classification of Functioning, Disability, and Health (ICF) framework. Results Symptoms of diabetes and the effort to regulate diabetes strongly impacted the ability to (remain in) work. Other barriers included physically demanding work, work pressure/stress, long commutes, and inflexible and irregular working hours, whereas facilitators included flexibility, a supportive work- and social environment, workplace accommodations, favourable employment conditions, diabetes disclosure and acceptance, and setting boundaries. While findings were mostly comparable, small, preliminary differences based on social identities emerged reducing working hours, coping mechanisms, diabetes acceptance, and a need to prove oneself. Conclusion Remaining in work with diabetes is shaped by diabetes-related challenges and workplace factors, with minor differences observed across genders and ethnic groups.