Work Disability Before and After Diabetes Diagnosis: A Nationwide Population-Based Register Study in Sweden

Abstract

Although diabetes has an independent effect on work disability, sex, age, education, and comorbid conditions play a significant role.

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

“…The results corroborate earlier evidence regarding the effect of diabetes and comorbid conditions on the excess risk of work disability (6)(7)(8). The study contributes to existing evidence by using comorbid conditions as time-dependent covariates and treating other diagnoses of disability pension as competing events (in diagnosis-specific analyses).…”

“…Identification of diabetes was based on having at least one of the following: (i) insulin or other diabetes medication [Anatomical Therapeutic Chemical (ATC) code A10] (13); (ii) in-or out-patient record with ICD-10 code E10, E11, E12, E13, or E14 as described previously (2,8). Of those identified as having diabetes, 7% were treated with both A10A (insulin) and A10B (other diabetes medication), 11% with A10A only, 67% with A10B only, and 15% none of these (diabetes diagnosis was based on hospital records only).…”

“…However, most studies included in this review did not take into account comorbid conditions either at baseline or during follow-up. A few earlier studies on the Comorbidity in diabetes and disability pension effect of comorbidity on work disability among people with diabetes suggest that the risk seems to be shaped by comorbid conditions (6)(7)(8). However, no previous study has examined the contribution of time-dependent comorbid conditions, ie, those that occur during follow-up, to the association between diabetes and work disability pension.…”

Health- and work-related predictors of work disability among employees with a cardiometabolic disease — A cohort study

“…Job strain, as indicated by low control and high strain [32], was calculated as: 'job demands' − 'job control' resulting in values ranging from −4 to 4, where higher score indicated higher strain [13]. Efforts and rewards were measured by mean response scores using one effort item (1-5) and three reward items (1)(2)(3)(4)(5), in which higher scores indicated higher efforts and higher rewards [33]. Effort-reward imbalance (ERI) was calculated as: 'efforts'/ 'rewards' resulting in values ranging from 0.2 to 5.0, where a higher score indicated a greater imbalance.…”

“…Although these diseases are important causes of work disability [1][2][3][4], having a cardiometabolic disease does not necessary lead to permanent exit from the labor market. However, factors that are associated with an increased risk of work disability in these patient groups are not well known.…”