World Diabetes Day – Expert Interview with Norbert Hermanns and Dominic Ehrmann (FIDAM)

Nowadays, people with diabetes can pursue nearly any profession. What has changed over the past 25 years?

Over the last few decades, diabetes management has changed dramatically. In the past, people often had to plan their day around their diabetes – checking blood sugar levels with finger pricks, timing insulin injections carefully, and worrying about sudden changes in glucose levels. Today, thanks to new technologies like continuous glucose monitoring and insulin pumps that automatically calculate and deliver the right amount of insulin, people with diabetes can keep track of their blood sugar in real time and respond more flexibly. Diabetes technology has dramatically changed the way blood sugar levels can be controlled – making diabetes management more effective and safe.

This has also contributed to an increased freedom and confidence in choosing the career paths they want – whether that’s teaching, engineering, or even flying a plane in some cases. Most importantly, attitudes have changed too. Employers and colleagues are more aware that diabetes can be managed successfully, which has helped reduce stigma and open more doors.

Do any professions still remain off-limits to people with diabetes?

There are still a few jobs where strict safety regulations apply – for instance, certain positions in the military, specific roles within the police, aviation, or heavy transport roles. These safety regulations are usually linked to the potential risk of low blood sugar (hypoglycemia), which could cause sudden dizziness, blurry vision, or loss of concentration. However, as diabetes management tools become more reliable and precise, many of these restrictions are being re-evaluated. The focus is shifting from the diagnosis itself to how well the individual person can manage their condition – and that’s real progress.

What risks or challenges do people with diabetes still face in the workplace today?

Managing diabetes is a bit like running a background program in your mind all the time. People need to monitor how food, stress, physical activity, and sleep affect their blood sugar. This constant mental load can be exhausting – especially in busy work environments.

There can also be emotional challenges, such as worrying about others’ reactions or feeling the need to “hide” the condition to avoid being treated differently. Understanding from managers and supportive colleagues can make a big difference.

In the survey, you conducted for MuSiC4Diabetes, you state that people with diabetes think about their condition for nearly 68 minutes a day. How does this affect the professional lives of those living with the disease?

To put it into perspective: The 70 minutes per day mean that people with diabetes think about their diabetes nearly every 13 minutes – and that’s every day. That’s a lot of time and effort per day thinking, planning, and adjusting – often without others even noticing. It shows how much invisible effort goes into staying healthy and productive.

At work, this mental effort can sometimes compete with other tasks and concentration. If you have to stop in the middle of a meeting to check your glucose or worry about how your lunch will affect your glucose levels, it can add an extra layer of stress. That’s why one of our goals in MuSiC4Diabetes is to reduce this mental load – to make diabetes management something that happens quietly in the background, so people can focus more fully on their lives and also their work.

There is no statistical evidence that people with diabetes are at higher risk of workplace accidents than people without diabetes. Why, in your opinion, do these stereotypes persist in public discourse?

It takes time until old beliefs are changed by new facts. In the past, before we had modern monitoring and insulin delivery systems, it was harder to manage and predict blood sugar swings, and that sometimes caused concern. But today, with advanced sensors and digital tools, people can detect and treat low or high blood sugar long before it becomes dangerous.

Still, stereotypes often come from a lack of understanding and from exaggerating isolated events where something went wrong. That’s why education and open dialogue at the workplace are so important – so that diabetes isn’t seen as a limitation but as a condition that can be managed effectively with the right tools and support.

The risk of experiencing a diabetes emergency is decreasing thanks to improved monitoring systems. How does the MuSiC4Diabetes Project contribute to further mitigating risks for people with diabetes?

New technologies have already made diabetes much safer to manage. Our project wants to take this a step further and focuses on making monitoring even smarter. We’re developing a system that not only measures glucose, but also two other relevant parameters. For example, when the body doesn’t have enough insulin, it can start producing ketones, which can lead to a serious condition called diabetic ketoacidosis. On the other hand, intense physical or mental stress can raise lactate levels, which can also affect metabolism and well-being.

Therefore, by continuously monitoring not only glucose but also ketones and lactate, we will get a more complete picture of what’s happening in the body. By combining these signals, the system can identify early warning signs that might otherwise go unnoticed and directly take consequences by automatically adjusting insulin delivery – for instance, when someone is heading toward a state of overexertion or metabolic imbalance.

This means greater safety and peace of mind, especially in the workplace. In short, by broadening what we monitor – beyond glucose alone – we aim to make diabetes management smarter, earlier, and more preventive.

The MuSiC4Diabetes team is developing an innovative and unobtrusive diabetes technology. What exactly does 'unobtrusive' mean, and how might it improve workplace experiences for people with diabetes?

“Unobtrusive” means it fits naturally into daily life – it doesn’t draw attention or require constant action or as one person with diabetes put it in one of our interviews: Making diabetes management as easy as brushing your teeth.

In our case, this means a system that works quietly in the background, that takes care of insulin delivery by using different bodily signals, that automatically adjusts diabetes management to different situations and that is fully implantable and therefore not visible from the outside – and the best part, that does all this without manual input from the person with diabetes. “Unobtrusive” thus means, reducing the mental load of people with diabetes, but also reducing the visibility of diabetes with an implantable systems so that the person cannot be identified and potentially differently treated as a person with diabetes. For someone at work, this can be a huge relief.