Diabetes and Lost Productivity (Presenteeism)

Angelica Lawson
11 Nov 2024
5 min read

One of the work-related effects of diabetes is the increase in lost productivity, also known as presenteeism. The American Diabetes Association discovered that presenteeism accounts for a large proportion of total costs of diabetes, reaching 62% of total costs and 87% of indirect costs among a database of employees in large US corporations.

Many studies carried out by Brod et al (2011, 2012, 2013, 2014) found that across US, Canada, and European Union countries, 23.8% of individuals who reported a non-severe hypoglycemia event (NSHE) at work missed a meeting or work  appointment or did not finish tasks on time. Among individuals experiencing an NSHE outside working hours (including nocturnal NSHE), 31.8% reported that they missed a meeting or work appointment or did not finish a work task on time due to the nocturnal NSHE. Additionally,  when compared with respondents with type 1 diabetes, those with type 2 appeared to experience more presenteeism associated with a NSHE. 

Moreover, a group of researchers reviewed the relationship between diabetes and presenteeism, and found that diabetic complications such as hypoglycemia, mood disorders, and neurological disorders significantly worsen presenteeism (Mori et al. 2019, 2020). This is supported by Taylor-Stokes et al. (2011) who found that as pain and numbness in the legs, feet and hands (diabetic neuropathy) becomes stronger, larger productivity loss occurs. This is significant as 57% of diabetics experience neuropathy as it is 1 of the 3 major complications arising from poor glycemic control and has also been linked to a 2000% higher risk of falling. 

Similarly, Mitchell et al. (2013) reported that 35.3% of employees who experienced at least 1 episode of hypoglycemia in a month, had work impairment in the prior 7 days which was approximately double of those without diabetes. 

Furthermore, fatigue is another symptom that drastically impacts worksite productivity and is commonly referred to as diabetic fatigue syndrome. Diabetic fatigue syndrome is defined as a multifactorial syndrome of fatigue or easy fatigability, occurring in people with diabetes, which may be caused by a variety of lifestyle, nutritional, medical, psychological, glycemia/diabetes-related, endocrine, and iatrogenic factors. Fatigue can cause your employees to feel a total lack of energy or “fogginess,” preventing them from performing tasks they would typically be able to do due to exhaustion. This chronic tiredness can significantly hinder productivity and work performance, as employees may take longer to complete tasks, struggle to concentrate, or even experience lapses in memory. As a result, diabetic fatigue syndrome exacerbates presenteeism and contributes to the hidden costs of diabetes in the workplace (Karla & Sahay, 2018). 

In summary, studies show that employees with diabetes experience higher levels of work impairment due to factors like hypoglycemia, neuropathy, fatigue, and other complications. The costs of these impairments extend beyond medical expenses, affecting productivity, increasing absenteeism, and raising long-term health risks. By investing in employee health, employers can cultivate a more engaged, productive, and healthier workforce, ultimately benefiting both the individual and the organization by addressing the implications of unmanaged diabetes.

To support employees with diabetes, employers can implement wellness programs that include regular health check-ups, education on diabetes management, and strategies for preventing complications. These initiatives not only reduce presenteeism but also improve employee engagement, create a healthier work environment, and enhance overall productivity.

Investing in employee health isn’t just about caring for their well-being—it’s a smart business decision. Companies that prioritize health see lower turnover rates, fewer workplace accidents, and stronger employee engagement. Ultimately, such investments lead to long-term cost savings, reduced hidden costs like presenteeism, and enhanced organizational performance, strengthening the bottom line.

If you'd like to learn more about how you can support your workforce in managing diabetes and its impact on productivity, feel free to reach out to us for more information.

References

American Diabetes Association (2018). Economic Costs of Diabetes in the U.S. in 2017. Diabetes care, 41(5), 917–928. https://doi.org/10.2337/dci18-0007

Brod, M., Christensen, T., Thomsen, T. L., & Bushnell, D. M. (2011). The impact of non-severe hypoglycemic events on work productivity and diabetes management. Value in Health, 14(5), 665-671.

Brod, M., Christensen, T., & Bushnell, D. M. (2012). Impact of nocturnal hypoglycemic events on diabetes management, sleep quality, and next-day function: results from a four-country survey. Journal of medical economics, 15(1), 77-86.

Brod, M., Wolden, M., Christensen, T., & Bushnell, D. M. (2013). Understanding the economic burden of nonsevere nocturnal hypoglycemic events: impact on work productivity, disease management, and resource utilization. Value in health, 16(8), 1140-1149.

Brod, M., Wolden, M., Groleau, D., & Bushnell, D. M. (2014). Understanding the economic, daily functioning, and diabetes management burden of non-severe nocturnal hypoglycemic events in Canada: differences between type 1 and type 2. Journal of Medical Economics, 17(1), 11-20.

Taylor-Stokes, G., Pike, J., Sadosky, A., Chandran, A., & Toelle, T. (2011). Association of patient-rated severity with other outcomes in patients with painful diabetic peripheral neuropathy. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 401-408.

Mori, K., Mori, T., Nagata, T., Nagata, M., Iwasaki, M., Sakai, H., Kimura, K., & Shinzato, N. (2019). Factors of occurrence and improvement methods of presenteeism attributed to diabetes: A systematic review. Journal of Occupational Health, 61(1), 36-53.

Mori, T., Nagata, T., Nagata, M., Otani, M., Fujino, Y., & Mori, K. (2020). The impact of diabetes status on Presenteeism in Japan. Journal of occupational and Environmental Medicine, 62(8), 654-661.

Mitchell, B. D., Vietri, J., Zagar, A., Curtis, B., & Reaney, M. (2013). Hypoglycaemic events in patients with type 2 diabetes in the United Kingdom: associations with patient-reported outcomes and self-reported HbA1c. BMC endocrine disorders, 13, 1-9.

Kalra, S., & Sahay, R. (2018). Diabetes Fatigue Syndrome. Diabetes therapy : research, treatment and education of diabetes and related disorders, 9(4), 1421–1429. https://doi.org/10.1007/s13300-018-0453-x