‘Diet and medication combined provides the biggest outcomes,’ says Constant Health’s Frances Wild
Diabetes should be one of the most tightly managed chronic conditions in Canadian workplaces. Yet, it continues to slip through the cracks, even as employers increasingly allocate coverage.
But as two health experts argue, one of the missing pieces that's currently missing in workplace strategy is structured, personalized nutrition counselling that should be embedded as a core part of diabetes care rather than an add‑on.
After all, Lisa Spriet, co-founder and dietician at NutriCanPro, highlighted that “structured nutrition counseling can overall reduce somebody's body weight by about 5 to 7 per cent” and that this modest loss “actually translates more to like a 30 to 40 per cent improvement in glycemic control as well as reduce risk of a diabetes,” she said.
“Diet and medication combined provides the biggest outcomes,” emphasized Frances Wild. “Some people don't want to go on the medication; some people can't go on to the medication, and some people don't need the medications. There's always going to be that cohort of people. But I don't think [nutrition counselling] is a healthier alternative.”
Still, Wild, who's a registered and lead dietician at Constant Health is particularly passionate about early dietary intervention.
"If we can get in really early, they could put their glucose levels into a non-diabetes range,” and that even long-term patients can see improvements in energy, beta cell function, and overall well-being, she said.
She stressed that effective management requires consistent, personalized support rather than one-off appointments as patients need guidance to interpret the wealth of data from glucose monitors and to develop sustainable habits. Wild also argues that dietitians should be considered a core pillar of diabetes care, equal in importance to medications and physician visits, and that coverage for ongoing nutritional support is critical.
Still, Spriet argues that employers need a more structured and proactive approach to diabetes prevention and management in the workplace. She stressed that organizations should first build broad awareness of rising diabetes rates and support healthier food environments.
“There should be some policies around what is allowed in the workplace,” underscored Spriet, who also suggests a balanced model where most available foods align with dietary guidance.
She is equally direct about benefit design, underscoring that meaningful nutrition counselling can’t be delivered on minimal coverage, noting the minimum needs to be $500. Additionally, Spriet noted that real behaviour change typically requires at least six sessions before seeing any improvement. Meanwhile, plans offering $750 to $1,000 per year see significantly stronger results because support can continue throughout the year.
Beyond benefits, she encourages HR teams to make nutrition care more accessible, whether by allowing daytime appointments, offering virtual consultations, or bringing dietitians into the workplace for educational sessions.
Spriet also highlights the financial case for earlier intervention. Early nutrition support can also delay or prevent the progression from low-cost treatments like metformin to far more expensive medications or insulin, as well as the downstream complications associated with uncontrolled diabetes.
'We're not doing a great job'
Additionally, Spriet emphasized that an aging workforce and an influx of demographic change are pushing up risk even before lifestyle enters the picture.
“We naturally lose some of our insulin sensitivity as we get older and we have an aging workforce. The other part has to do with our changes in our overall population,” said Spriet, adding Canada’s shifting population mix as a factor, explaining that certain groups experience higher diabetes incidence once they are immersed in Canada’s environment.
“Additionally, obesity is probably the biggest driver of type 2 diabetes. And we're really not able to get a handle on that either. We're just not doing a great job overall,” underscored Spriet.
For many employees, the experience of having diabetes at work is shaped as much by culture and stigma as by medications, acknowledged Spriet. Food is everywhere in corporate life, but it’s all too often the worst kind for blood sugar.
Spriet described the typical catered meeting as “cookies and croissants and these highly processed carbohydrate-containing foods that are really hard for those who have diabetes,” adding that, “for some people like those foods are really harmful to their health,” she said. Even when healthier options show up beside the treats, stigma can push people away from the better choice.
Meanwhile, Wild also sees the same dynamic in how people talk about diabetes itself. She argued that “empathy is incredibly important” because casual comments like “you just need to eat less sugar” barely scratches “one per cent of what this is,” she said.
Stigma, the most significant barrier
According to Wild, stigma blends with health bias, so that instead of seeing diabetes as a medical condition, “people then don't feel like they want to report” and feel pushed toward quick-fix advice like “you need to go on a keto diet and you'd be fine,” she said. Yet, Wild emphasized how diabetes management is “incredibly complex,” noting that it can feel like a “full-time job in itself” due to the many factors influencing outcomes.Where both experts converge is on the missing link of
Wild identifies stigma as the most significant barrier preventing people from seeking diabetes care. She noted that individuals with chronic conditions such as asthma are never told to “try harder,” yet people with diabetes or obesity often encounter unsolicited judgment or advice. She believes this reinforces the false idea that diabetes reflects a personal failure rather than a medical issue, which she describes as “infuriating.”
She also points to the evolving nature of treatment, noting that while medications have advanced significantly, improper use or lack of guidance can still lead to poor management.
“Medications have come a huge way from where they were even 15 years ago… Sometimes there’s a stigma associated with the different medications, or employees just don't know when to take them. For example, I saw someone last week taking a medication just at the wrong time of the day. That was causing havoc and that can cause poor management, so there's so many different factors.”
