Background and Aims: To our knowledge, no study has yet examined diabetes related work disability from a life course perspective. This study estimated the number of years people with type 1 and type 2 diabetes lost in a 30-year work life span compared to people without diabetes.
Method: Individuals aged 18-65 years, diagnosed with type 1 (n=33,188) or type 2 diabetes (n=81,930) were identified from national registers from the entire Danish population and age and gender matched with controls without diabetes (n=663,656), for period 2000-2017. Work Life Expectancies (WLE) in years were estimated as time in employment from age 35 to 65. We used a life table approach with multi-state Cox proportional hazard modelling (95% Confidence Intervals: CI). Age was the underlying time-axis. Inverse probability weights accounted for differences between populations. Analyses were performed separately for sex, educational status, and types of diabetes in 5-year age intervals.
Results: Individuals with type 1 diabetes and type 2 diabetes had significantly shorter WLE compared to people without diabetes in the 30-year span. Type 1 diabetes: WLE ranged from 8 years shorter among women with low education [-8.0; CI: -11/-5.0] to 4 years shorter [-4.4; CI: -6.6/-2.3] with high education; WLE in men ranged from -6.4 [CI:-8.7/-4.0] with low education to -3.0 [CI:-4.5/-1.5] with high education. Type 2 diabetes: WLE ranged from -6.5 [CI: -8.9/-4.0] in women with low education to -2.9 [CI:-4.5/-1.3] with high education. WLE in men ranged from -7.0 [CI: -9.4/-4.5] with low education to -3.7 [CI: -5.4/-2.0] with high education.
Conclusion: The substantial number of years lost in 30-year work life span of people with type 1 or type 2 diabetes highlight needs to prevent individual and societal consequences of diabetes related disability. Preventive strategies are particularly relevant for people with low education.
M.A. Nexo: None. J. Pedersen: None. B. Cleal: None. I. Andersen: None. J.B. Bjorner: None.