Burden of Diabetes on the Ability to Work

A systematic review

  1. Jocelyne Moisan, PHD1,2,3
  1. 1Chair on Adherence to Treatments, Laval University, Quebec City, Quebec, Canada
  2. 2URESP, Centre de recherche du CHU de Québec, Quebec City, Quebec, Canada
  3. 3Faculty of Pharmacy, Laval University, Quebec City, Quebec, Canada
  1. Corresponding author: Marie-Claude Breton, marie-claude.breton{at}

Type 2 diabetes is an increasingly common disease (1) that places a considerable economic burden on society. An estimated 171 million people were suffering from diabetes in 2000, and this number could total 366 million by 2030 (1). Type 2 diabetes accounts for more than 90% of all diabetes cases, and it often appears in middle age (2). In 2010, the prevalence of diabetes in the U.S. was 11.3 and 26.9% among individuals aged 20 years or over and 65 years or older (2), respectively.

In 2007, costs related to diabetes in the U.S. were an estimated $174 billion; $116 billion in direct costs and $58 billion in indirect costs (3). Direct costs include the cost of personal expenditures, drugs, and health care services, whereas indirect costs include lost productivity at work. Lost productivity at work may be measured through absenteeism (time lost from work due to illness), presenteeism (time at work impaired due to illness), productivity (time lost from work due to illness plus time at work impaired due to illness), or early retirement (retirement before the official retirement age due to illness).

Lost productivity at work is an important concern for employees, employers, and society. Moreover, the complications related to diabetes are a major cause of disability, reduced quality of life, and death (4). Employees with diabetes may stop working prematurely (58) and may experience unemployment (7,912), which could translate into a reduction in earned income and savings (13) and loss of self-esteem (14). For employers too, lost productivity due to absenteeism (6,8,13,1523), presenteeism (17), and early retirement (57) is an important economic issue.

To the best of our knowledge, there are no published systematic reviews answering the following question: Do individuals …

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