Employer Playbook

www.diabetes.org/atwork
Stop Diabetes @ Work
T he majority of adults spend most of their waking hours at their place of employment, yet not enough preventive
health education and diabetes awareness is taking place in this most convenient of venues – right where people work.

The connection between work environments, employee health, and employee productivity is clear. Prevention makes
good business sense.
For companies large and small, a key to controlling spiraling health costs is to help employees prevent and man-
age diabetes. Strategies for preventing and controlling diabetes can also reduce the risk for heart disease, stroke,
high blood pressure and high cholesterol.
For that reason, the American Diabetes Association offers Stop Diabetes @ Work (SD@W), an evidence-based
program that, in cooperation with employers, addresses diabetes awareness, detection, prevention, and successful
management. This program can be used as a stand-alone healthy worksite initiative or it can be used in conjunc-
tion with a larger worksite wellness program.
This healthy worksite initiative offers Basic and Premium models:

Basic Elements of SD@W Premium Elements of SD@W

Online Employer Portal American Diabetes Association Weight Talk®

Employers will have access to an
online portal with turnkey resources
including:
■■ Handouts that can be co-
branded
■■ Newsletter articles and recipes
to communicate healthy lifestyle
messages on a monthly basis
■■ Online and paper tools to
track progress
■■ Facts to help make the busi-
ness case for worksite wellness
■■ Resources to create a healthy
worksite community
Online Employee
Resources
Employees will have access to the
American Diabetes Association’s
award-winning interactive tools.
Employers can share links on the
company’s existing wellness portal
or the Association can create a co-
branded webpage that provides
seasonal materials about healthy
lifestyles.
This weight loss program, offered nationwide
through SD@W, help employees lose weight
to prevent prediabetes, type 2 diabetes and
diabetes complications with personal coaching
delivered via telephone and online support.
The evidence-based program is designed to
help participants achieve measurable, sustainable weight loss through highly
personalized support.
Please notify your local American Diabetes Association if you are interested in
more information.
Local American Diabetes Association Resources
You can work with your local American Diabetes Association to develop a
healthy worksite program based on your needs.
Depending on location and market availability, your local American Diabetes
Association can also offer a lunch and learn series based on the tenants of the
Diabetes Prevention Program, health fair participation with Association experts,
and print materials written at a 5th grade level in English and Spanish.
You can participate in American Diabetes Association team-building activities
that take place in your community. By participating in one of the Association’s
signature events, Step Out: Walk to Stop Diabetes or Tour de Cure, you can
reinforce the physical activity components in this program and be recognized in
your community as a company who is dedicated to wellness.
How to Implement
Stop Diabetes @ Work
Access Online Resources – Talk to your local American Diabetes Association representative about
1 accessing online tools for you and your employees.

Work with Your Wellness Team – Share online resources with your wellness team and create a
2 promotional plan using the communication tools and monthly calendar. If you don’t have a
wellness team, create one using the SD@W wellness team job descriptions.

Announce SD@W – Once everything is ready, you can send your employees an email to announce
3 the program. The email can be found in the SD@W online employer portal.

Distribute the Diabetes Risk Test – More than 94 million American adults are at risk for type 2
4 diabetes or are unaware they have diabetes. Create awareness by making the Diabetes Risk Test
available: online, PDF or poster.

Hang Posters – Print and hang “Take the Stairs” which can be customized to include your SD@W
5 vanity employee portal URL or your company’s wellness website.
Spread awareness to the 7 million Americans with undiagnosed diabetes and the 79 million Americans
with prediabetes. Hang Diabetes Risk Test posters in waiting areas or break rooms.
Remind employees to make wellness a priority by hanging Tips for Healthier Living @ Work signs or
distributing card-size reminders to employees..
Share Education Resources – Each month, include SD@W articles and recipes in your company
6 newsletter or intranet. If your company does not have these resources, distribute Healthy Living
Worksheets (that can be co-branded with your company logo) on various lifestyle topics. Monthly
themes will be mirrored on the online employee portal where employees can find more in-depth
information on the topic. All education resources can be downloaded from the employer portal.

Build a Team and Engage Employees – Work with your local American Diabetes Association to
7 learn about teambuilding opportunities and to include local Association events in your annual
wellness planning. By forming a team of employees for the Association’s Step Out: Walk to Stop Diabetes
or Tour de Cure, you can reinforce SD@W’s physical activity messages. You could create your own
wellness event with the Association’s Community Walk to Stop Diabetes. Start moving with the Walking
Group Toolkit and training plans.

Optional: Support Weight Loss – Offer the American Diabetes Association Weight Talk® or American
Diabetes Association Weight Talk® D program to your employees. (Available for companies with more
than 1,000 employees.)
SD@W Tools
Online Resources
Share some of the Association’s online tools
with your employees:
■■ Diabetes 24/7 - This personal health re-
cord allows people to better manage their
diabetes by tracking data and sharing data
with health care providers.
■■ Living with Type 2 Diabetes - This
12-month program for people newly di-
agnosed with diabetes provides online or
mailed packets with information to man-
age and live with diabetes.
■■ MyFoodAdvisor - This award-winning
nutrition tool allows users to explore foods,
track their daily meals, find healthy substitu-
tions, analyze recipes and find new recipes.
■■ My Health Advisor - This powerful risk as-
sessment tool demonstrates how making
lifestyle changes can lower users’ risk for
developing type 2 diabetes and its compli-
cations over an 8–year period.
■■ Recipes for Healthy Living - Each month, new
recipes, meal plans and cooking tips are post-
ed. Users can find quick-and-easy meal ideas,
gluten-free options or foodie-type recipes.
Diabetes Risk Tests
More than 94 million Americans are at
highest risk for developing diabetes - or - are
unaware they have the disease. Hang Diabe-
tes Risk Test posters or distribute the Risk Test
handouts to your staff.
Healthier Living @ Work Tips
Set the tone for a healthier workplace by dis-
tributing these reminders to your employees.
Stair Posters
Research shows highlighting
stair routes in office buildings
increases stair use – and – the
number of steps someone
takes in one day. Research also
shows that sitting for periods
of time, even if you are active during other parts
of your day, is detrimental to your health.
Wellness
Calendar
Each month, new topics will be
highlighted on the employee
portal. Supporting materials, including articles
and recipes, will be available on the employer
portal. This will help reinforce healthy lifestyle
messages all year round. The calendar can be
found on the employer portal so you can plan
your wellness strategy in advance.
American
Diabetes
Association Healthy
Living Worksheets
These worksheets, available in
English and Spanish, can be
customized with your company logo. Topics in-
clude preventing and managing diabetes, healthy
eating, exercising, and changing and monitoring
habits. You can download these handouts from
the SD@W employer portal.
Healthy Meetings Guide
In the next section of this playbook, learn how
to integrate healthy behaviors into your overall
corporate culture and become a more health-
conscious and productive place to work.
SD@W Tools
(continued)

Lunch and Learn Series

Talk to your local American Diabetes Associa-
tion office about hosting a series of lunch and
learns on the following topics:
■■ Diabetes 101
■■ Healthy Eating
■■ Physical Activity
■■ Weight Loss
■■ Surviving the Holidays
■■ Heart Health
■■ Diabetes Head to Toe
Community Walk to
Stop Diabetes Kit
Walking Group This kit provides everything you need to host a
Create a walking group for your employees in walk at your company and raise funds to sup-
five easy steps. Promotional resources also are port the Associa-
available. tion’s mission.

Tour de Cure Training Plan

This training program, found on the employer Association’s
portal, was designed for someone who can al- Print Materials
ready cycle 10 miles Talk to your American Diabetes Association
at a 10 mph pace contact about the variety of diabetes preven-
without difficulty. tion and management education resources
available for order.
■■ Choose to Live
Step Out: Walk to Stop
Diabetes Training Plan ■■ Create Your Plate
This walking plan has been developed for ■■ Healthier Eating One Step at a Time
those who have not been doing any struc- ■■ Top 5 Ways to Stop Diabetes and Get
tured fitness walking program. Download it Healthy Right Now!
from the employer portal ■■ What Can I Eat
and set a 10-week goal
to walking a 5K. ■■ What You Need to Know Series
 FACT SHEET

Improving Health
and Productivity
The twin epidemics of type 2 diabetes and obesity have
increased significantly in the last 30 years.

R esearch has shown that lifestyle modifications can reverse this trend
and improve blood pressure, cholesterol and blood glucose levels.
Lifestyle changes also can lower the risk of developing type 2 diabetes,
heart disease, stroke, certain types of cancer, and sleep apnea.

Investing in worksite wellness programs that encourage, educate and mo-

tivate employees to make lifestyle modifications is cost-effective and can
lead to greater productivity.
For example, employees with diabetes who improve their glucose control
have significantly higher productivity and lower absenteeism.1
Health plan expenses are 26% lower for employees whose diabetes is in
good control than for those employees whose diabetes is in poor control.2
Critical need to
focus on diabetes
in the workplace

Diabetes by the Numbers Between 25-30% of com-

panies’ yearly medical costs
spend on employees with
The diabetes epidemic continues to grow and your current and cardiometabolic risk factors3:
future employees are being affected at an alarming rate. Recent esti-
mates show 1 in 3 American adults4 will develop type 2 diabetes by ➔ Diabetes
2050 if current trends continue. Currently : ➔ Heart disease
■■ There are 29.1 million children and adults in the U.S. with diabe- ➔ Obesity
tes. That’s 1 in 9 adults.
■■ An additional 86 million American adults have prediabetes,
➔ High blood pressure
and are at high risk for developing type 2 diabetes. That’s 1 in 3 ➔ Abnormal cholesterol
adults. ➔ Physical inactivity
■■ Nearly 1 in 4 teenage children now have type 2 diabetes or pre- ➔ Cigarette smoking
diabetes in the U.S.

1
Testa, MA et al. Health economic benefits and quality of life during improved glycemic control in patients with type 2 diabetes. JAMA 1998; 280(17): 1490-1496
2
Gilmer, TP et al. The cost to health plans of poor glycemic control. Diabetes Care 1997; 20(12): 1847-1853
3
Anderson DR, et al. The relationship between modifiable health risks and group-level health care expenditures.. Am J Health Promot. 2000;15:45–52.
4
Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Department of Health
and Human Services; 2014.
Economic burden of diabetes in the U.S.
Total annual cost of diagnosed diabetes in 2012 was $245 billion.5 The American Diabetes Association
estimates that $1 in $5 health care dollars is spent caring for someone with diagnosed diabetes.
Direct costs total $176 billion
■■ Hospital inpatient care (43%)
■■ Diabetes medication and supplies (12%)
■■ Retail prescriptions to treat complications
of diabetes (18%)
■■ Physician office visits (9%)
■■ Nursing/residential facility stays (8%)
■■ Other (10%)
Indirect costs total $69 billion
■■ $5 billion – national cost for 25 million
workdays absent
■■ $20.8 billion – national cost for reduced
performance at work (presenteeism),
estimated at 113 million lost workdays
■■ $2.7 billion – national cost for 20 million
days of productivity loss for those not in
the labor force
■■ $21.6 billion – national cost for more than
130 million lost work days a year
■■ $18.5 billion - national cost of lost productive
capacity due to early mortality
Good news:
Diabetes and its complications can be prevented
➔ Research shows type 2 diabetes
can be prevented or delayed by
58% through lifestyle interven-
tion. Losing 7% of body weight
(15 pounds if you weigh 200
pounds) and moderate exercise
(brisk walking) 30 minutes a
day, 5 days a week, can make a
significant difference in lower-
American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2012, Diabetes Care. Diabetes Care. 2013;36:1-14.
5
According to Kaiser Family Foundation data, the
American Diabetes Association’s workplace cost
calculator estimates that for a company with 1,000
employees:
■■ 100 employees have diabetes
■■ 27 of them are undiagnosed
■■ 250 have prediabetes
■■ $2.7 million is the average annual insurance cost
for employees with diabetes and prediabetes
■■ $912,438 is the annual increased cost if
50 percent of employees with prediabetes
develop diabetes
These figures do not include
additional costs for gestational
diabetes, prediabetes and
undiagnosed diabetes.
ing one’s risk for developing active and control their A1C,
type 2 diabetes. blood pressure and cholesterol
levels.
➔ A healthy lifestyle can help
prevent or delay costly diabetes
Investing in awareness, education
complications such as heart
and team building can lead to im-
attack, stroke, kidney disease,
provements in employee health and
blindness and amputation.
productivity. The American Diabetes
People with diabetes should
Association’s Stop Diabetes @ Work
maintain a healthy weight, stay
resources can help.
Healthy Meeting Guide

www.diabetes.org/atwork
Healthy Meeting Guide
Providing employees with healthy food choices in the workplace can go a long way to support
a culture of wellness. The challenge is determining what constitutes “healthy,” especially in an
age in which supposedly “good-for-you” foods are promoted everywhere you turn.
A s an employer, you can set an example. Your
influence can encourage employees to make
lifestyle changes and help food service compa-
nies recognize the value of offering healthier
menu items. In addition, you can practice what
you preach and demonstrate you believe that a
healthy diet is the cornerstone for a healthy life.
Overweight/obesity is a leading risk factor for de-
veloping type 2 diabetes and cardiovascular dis-
ease (which itself is the most serious complication
of diabetes). Research shows that if you lose 7%
of your body weight (15 pounds if you weigh 200
pounds) by reducing the number of calories you
eat and becoming more physically active, you can
reduce your risk for type 2 diabetes by nearly 60%.
This guide will help you integrate healthy behav-
iors into your overall corporate culture. Try inte-
grating changes slowly, perhaps in conjunction
with a Stop Diabetes @ Work lunch and learn or
Integrate healthy behaviors
into your overall corporate
culture to prevent type 2
diabetes, heart disease and
other major cost-drivers.
during a specific awareness month. Over time,
your company can become a more health-con-
scious and more productive place to work.
Physical Activity: One Half of the
Healthy Meeting Equation
There are benefits to adding physical activity to
your meeting. You can increase energy and partici-
pation from your attendees.
There are a few different ways you can incorporate
physical activity into your meeting depending on
your timeframe:
■■ Stand up and stretch for 1-2 minutes.
■■ Take a 5-minute walk break.
■■ Break for 15-30 minutes and go on a group walk.
■■ For meetings with outside groups, point out
the stairs at the beginning of the meeting.
■■ Give permission to attendees at the beginning
of the meeting to stand as needed during the
meeting to stretch, stand or “pace” the room.
Catering Healthy Meetings
There are many ways you can start implement-
ing healthy eating guidelines for your meetings,
catered functions and events. If possible, display
the nutrition content for the food you are serving.
This will help your employees make healthy food
choices. Work with your caterer while negotiating
the contract to provide healthy food and provide
nutrition information for the food choices avail-
able. You can use the American Diabetes Associa-
tion’s MyFoodAdvisor (www.diabetes.org/mfa) to
find the nutrition content of thousands of differ-
ent types of food.
Preparation
Entrees and side dishes should be prepared using
minimal oils that are rich in healthy fats such as
olive oil, canola oil and corn oil. Deep-fried foods
(e.g. fried chicken, French fries) should be avoided
as they are very high in calories and unhealthy
fats. Low-fat cooking methods, such as grilling,
broiling, sautéing, poaching, roasting, baking,
stewing, microwaving, or braising, are recom-
mended.
Entrees
Portion sizes matter! Request 3-4 ounces or
smaller portions of fish, chicken, turkey or other
lean meats. Offer a vegetarian alternative at all
meals. Choose reduced-fat cheese when available.
Sauces/Dressings
Serve foods with dressings and sauces on the side
or pass them separately. Offer oil and vinegar in
separate containers as an alternative salad dress-
ing. Offer light or fat-free dressing options made
with healthy fats (olive oil, canola oil, corn oil) if
available. Whipped butter, trans-free margarine
and reduced or low-fat sour cream can be served
on the side for items like rolls or baked potatoes.
Avoid sauces made with cream or sour cream as
they are very high in calories and unhealthy fats.
Vegetables and Fruit
Offer vegetables and/or fruit at every eating oc-
casion. All are acceptable. Provide more than one
choice when possible.
Soups
Broth-based soups are best. Avoid cream-based
soups.
Salads
Include plenty of vegetables in salads and stay
away from high-fat meats like bacon and other
cured meats. Offer a salad at all lunch and dinner
meals when possible. Avoid high-fat salads such
as potato salad and macaroni salad.
Dairy
Dairy can be high in fat and calories. When serving
coffee and tea, you can provide half and half but
be sure to provide at least one type of lower-
fat milk, such as 2% or skim. Serve reduced-fat
yogurt, cheese and sour cream.
Breads/Cereals
Provide whole grain breads, crackers and side
dishes such as brown or wild rice blends or whole
wheat pasta when possible. Avoid prepared
cereals with significant added sugar.
Dessert
If dessert is served, keep portion sizes small. Try
mini or bite-sized desserts. Try fruit-based or low-
fat dairy desserts such as a fruit tart. Cobbler, fresh
berries with chocolate sauce, or low-fat ice cream.
Provide fresh fruit at every meal as a dessert option.
Beverages
Offer water, unsweetened tea, coffee, diet soda, or
other sugar-free drinks. Avoid all beverages with
added sugar including regular soda, lemonade,
sweet tea, fruit punch and sports drinks. Serve
reduced-fat or low-fat/non-fat milk instead of
whole milk.
Healthy Menu Ideas
Breakfast ■■ When serving pizza, choose thin crust that is
made from whole grain flour. Ask for less cheese
Choose healthy options:
and more vegetables. Skip the meat. Make sure
■■ Fresh fruit you have salad and fruit available too.
■■ Reduced-fat yogurt and fruit parfaits ■■ Serve broth-based-soups.
■■ reduced-fat cheese if available ■■ When offering pastas, serve with non-cream
■■ Eggs any style sauces on the side.
■■ Whole grain cereal with minimal added sugar, ■■ Provide plenty of vegetables and sliced or
small whole grain waffles/pancakes, mini whole fruit.
whole wheat bagels, whole wheat English ■■ Offer fish, shellfish, poultry such as chicken
muffins, mini bran muffins without the skin, and lean meats trimmed of
■■ Oatmeal with mix-ins such as chopped nuts, all visible fat.
dried fruit, and cinnamon
Stay away from:
■■ Jellies, peanut butter*, whipped butter, trans-
free margarine, reduced-fat cream cheese ■■ High fat processed meats including hot dogs.
■■ Canadian bacon, turkey bacon or turkey sausage ■■ High calorie sides such as potato salad, potato
■■ Water, coffee, tea, and low-calorie beverages chips, macaroni and cheese and cream-based
including a selection of 100% fruit juices soups.
Instead of: Breaks/Snacks/Desserts
■■ Pastries, biscuits, full-size muffins, croissants,
Consider serving these items to keep energy levels
and donuts
high for the duration of your meetings:
■■ Sauces for eggs
■■ Regular bacon and sausage ■■ Nuts*
■■ Sugary cereal, granola, and breakfast bars ■■ Fresh fruit
■■ Vegetables with hummus
Lunch & Dinner ■■ Unbuttered popcorn
Consider these ideas for your next lunch or dinner ■■ Non-fat yogurt
meeting: ■■ Whole grain chips with salsa, bean dip or guacamole
■■ Make half the plate (if plated) or half the dishes Instead of:
salads or vegetables. ■■ Cookies, brownies, muffins, cakes, or pastries
■■ Request that all grains including side dishes ■■ Snack or granola bars
and breads be 100% whole grain (i.e. brown
or wild rice, whole wheat pasta, 100% whole
wheat bread or rolls).
■■ Offer “make your own” salad, sandwich or pota-
to bar. Include plenty of vegetables, lower-fat
cheese and lean meats or lower-fat cold cuts.

*Be mindful of nut allergies.