Background: According to previous research, self-care of diabetes in the workplace poses a number of challenges in the world. Police officers have high risk of type 2 diabetes mellitus (T2DM) and they are stereotyped as being physically strong. Several countries report social stigma in diabetes; a study in Denmark reports that 23% of patients with T2DM did not disclose their status to their employer. Disclosure of diabetes status may be a key to self-care for T2DM in the workplace, however, there is lack of empirical evidence in this area of research in Japan.

Aim: The purpose of this study was to investigate the reasons for disclosure of diabetes status among different occupations, particularly among Japanese police officers. 

Methods: This is an exploratory qualitative study conducted from January to June 2017 at a secondary hospital in Kyoto, Japan. We targeted male outpatients diagnosed with T2DM with current or previous work. The study employed in-depth interviews guided by semi-structured questionnaires, which were audio-recorded, transcribed, manually coded, and analyzed through thematic analysis.

Results: We recruited 24 subjects, between 40 and 69 years of age, 7 police officers, 7 retired police officers and 10 non-police occupations. Five themes emerged from the interviews to investigate the reasons of disclosure of T2DM in the workplace: negative beliefs about diabetes, uncertainty of diabetes after diagnosis, features of police officers, differentiation of decision to disclose in the workplace and effects of disclosing. All participants, regardless of occupations, had disclosed their T2DM to their manager out of necessity. However, some of the participants tend to conceal their T2DM from colleagues because they are concerned about the reaction of their colleagues and they experience no inconveniences. Regardless of occupation and reasons for disclosure, revealing their T2DM in their workplace has had many positive effects. There were many common reasons for disclosure, however, the reasons among police officers were often explained based on the police culture and prior experiences as police officers. 

Conclusions: Disclosure of T2DM might have health promoting effect in the workplace including police workplace. However, considering that the reasons to disclose among police officers are influenced by characteristics of their job, intervention in this group should be respecting these characteristics. Additionally, reducing the negative beliefs about diabetes in society would be important to encourage disclosure of T2DM in the workplace, which in turn could facilitate its management.

Disclosure of diabetes status among Japanese police officers: a qualitative study