Contribution of comorbid conditions to the association between diabetes and disability pensions: a population-based nationwide cohort study

Ervasti, Jenni; Virtanen, Marianna; Lallukka, Tea; Pentti, Jaana; Kjeldgård, Linnea; Mittendorfer‐Rutz, Ellenor; Tinghög, Petter; Alexanderson, Kristina

doi:10.5271/sjweh.3556

Cited by 7 publications

(6 citation statements)

References 18 publications

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“…Diabetes mellitus is a chronic endocrine disorder, characterized by hyperglycemia and other metabolic disorders of fat, protein and electrolytes due to absolute or relative insulin deficiency (1). Epidemiological data suggest that diabetes-induced cardiovascular complications are a leading cause of diabetes-related mortality and disability (2). Diabetes-induced cardiovascular complications include macrovascular and microvascular diseases (3), of which vascular endothelial cell apoptosis is considered to be an initial event and pathological basis (4).…”

Section: Introductionmentioning

confidence: 99%

High glucose induces apoptosis of HUVECs in a mitochondria‑dependent manner by suppressing hexokinase 2 expression

Zhang

Guo

et al. 2019

Exp Ther Med

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Hyperglycemia in patients with diabetes induces vascular endothelial cell apoptosis and subsequent vasculopathy. The aim of the current study was to investigate the pathological mechanism of hyperglycemia-induced endothelial cell apoptosis and vasculopathy using human umbilical vein endothelial cells. As high glucose-induced apoptosis is caused by elevated mitochondrial permeability-mediated release of mitochondrial cytochrome c, the current study examined voltage-dependent anion channel (VDAC1), the controller of mitochondrial permeability, and its regulators, hexokinase2 (HK2), Bcl-2 and Bax. The current study demonstrated that HK2 may be involved in high glucose-induced cell apoptosis, as HK2 overexpression partially reversed high glucose-induced downregulation of mitochondrial/cellular HK2 and Bcl-2 as well as upregulation of mitochondrial Bax. These results suggest that HK2 overexpression partially reversed the reduced binding of HK2 and Bcl-2 and the enhanced binding of Bax to VDAC1, which reduced the high mitochondrial permeability observed under high-glucose conditions. Furthermore, high glucose reduced HK2 transcription via down-regulation of the HK2 transcriptional factor, peroxisome proliferator activated receptor γ (PPARγ). Taken together, these results suggest that PPARγ/HK2 may be novel targets for the prevention of diabetic vasculopathy.

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Section: Introductionmentioning

confidence: 99%

High glucose induces apoptosis of HUVECs in a mitochondria‑dependent manner by suppressing hexokinase 2 expression

Zhang

Guo

et al. 2019

Exp Ther Med

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“…For example, a previous assessment found that depression, musculoskeletal problems, and multiple co-morbid conditions all increased the likelihood of receiving disability pensions. 15 Recognizing these broader consequences of diabetes on governmental finances, we sought to quantify the effects of T2D on fiscal outcomes for the Swedish government based on delays in achieving glycaemic treatment targets. 16 Building on evidence showing the impact of diabetes and related complications on work activity, a fiscal analysis was conducted that describes how efforts to reduce clinical inertia in the treatment of T2D can influence future government tax revenues and transfer payments (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…These complications have also been linked to an increased need for disability pensions that can increase costs for governments (but are omitted from economic evaluation because transfer payments redistribute income and wealth without directly absorbing resources or creating output). For example, a previous assessment found that depression, musculoskeletal problems, and multiple co‐morbid conditions all increased the likelihood of receiving disability pensions 15 …”

Section: Introductionmentioning

confidence: 99%

The public economic burden of suboptimal type 2 diabetes control upon taxpayers in Sweden: Looking beyond health costs

Kotsopoulos

Connolly

Willis

et al. 2022

Diabetes Obesity Metabolism

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Aim: To estimate the fiscal burden for taxpayers in Sweden associated with type 2 diabetes (T2D) attributed to diabetes-related complications in patients failing to meet HbA1c targets.Material and Methods: We developed a public economic framework to assess how changes in diabetes-related complications influenced projected tax contributions and government disability payments for people with T2D. The analysis applied accepted disease-modelling practices to estimate different rates of diabetes-related complications based on an HbA1c of 6.9% (52 mmol/mol) and of 6.0% (42 mmol/mol). We adjusted the employment activity rates for those experiencing T2D-related events, applying age-specific earnings to estimate lifetime tax losses. Furthermore, the likelihood of receiving payments for health-related employment inactivity was estimated.Direct healthcare costs are excluded from this analysis. Results:The estimated per person earnings loss for immediate and delayed HbA1c control was Swedish krona (SEK) 42 299 and SEK 44 157, respectively, over 10 years. The lost employment activity of people with T2D translates to lost tax revenues of SEK 23 265 and SEK 24 287 for immediate and delayed control, respectively. The estimated difference in disability payments was SEK 538. Combining the tax revenue loss and excess disability payments defines the broader fiscal costs, where we observe combined fiscal losses that favour immediate and sustained control by SEK 1560 over 10 years. Conclusions:We show that conducting fiscal analysis of diabetes interventions offers an enriched perspective capturing a range of costs that fall on government in relation to lost tax revenue and disability payments. Tax-financed health systems may benefit from broadening the consideration of costs and benefits when evaluating new interventions and treatment practices.

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“…Musculoskeletal (MS) pain is among the most common co-existing diseases among patients with T2D [3][4][5][6] and significantly associated with T2D [18][19][20][21]. MS pain has been shown to have a negative influence on activity limitations and on the odds of disability [22,23], and be negatively associated with self-care behaviours, such as physical activity levels [24] and medication adherence [25]. Moreover, people with MS pain often report psychological problems [26], which are also suggested to be associated with T2D treatment [27].…”

Section: Introductionmentioning

confidence: 99%

Association of musculoskeletal pain with the achievement of treatment targets for type 2 diabetes among primary care patients

Heikkala

Hagnäs

Jokelainen

et al. 2022

Primary Care Diabetes

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Contribution of comorbid conditions to the association between diabetes and disability pensions: a population-based nationwide cohort study

Cited by 7 publications

References 18 publications

High glucose induces apoptosis of HUVECs in a mitochondria‑dependent manner by suppressing hexokinase 2 expression

High glucose induces apoptosis of HUVECs in a mitochondria‑dependent manner by suppressing hexokinase 2 expression

The public economic burden of suboptimal type 2 diabetes control upon taxpayers in Sweden: Looking beyond health costs

Association of musculoskeletal pain with the achievement of treatment targets for type 2 diabetes among primary care patients

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