Sickness in diabetes
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Sickness in Diabetes: An Overview
Increased Sickness Absence in Diabetic Employees
Sickness Absence Rates and Duration
Research consistently shows that employees with diabetes experience higher rates and longer durations of sickness absence compared to their non-diabetic counterparts. A study conducted in Ljubljana found that diabetic employees had a mean sickness absence frequency of 0.89 times per year, compared to 0.56 times for non-diabetic employees, with a significant difference in the total duration of sickness absence (31.71 days vs. 16.57 days). Similarly, another study in a large engineering factory reported that diabetic employees had a mean sickness absence of 32 days per year compared to 20 days for non-diabetic employees, although this difference was not statistically significant due to the variability in sickness absence. Furthermore, insulin-treated diabetic employees were found to lose more working days (13.3 days per year) compared to their non-diabetic counterparts (5.7 days per year).
Impact of Diabetes Control on Sickness Absence
The level of diabetes control, as measured by glycosylated hemoglobin (HbA1), also plays a crucial role in sickness absence. Employees with poorly controlled diabetes (HbA1 > 8.5%) had a higher frequency of sickness absence, more working days lost, and longer average durations of absence compared to those with well-controlled diabetes (HbA1 ≤ 8.5%). This indicates that better management of diabetes can potentially reduce the incidence and duration of sickness absence.
Sick-Day Management in Diabetes
Importance of Monitoring and Ketone Testing
Effective sick-day management is essential for individuals with diabetes to prevent metabolic deterioration. Increased monitoring of blood glucose and assessment for ketosis are critical during illness. Traditionally, urine testing for ketones has been used, but new technology for self-monitoring of blood 3-hydroxybutyrate (3HB) levels offers a more effective alternative. The American Diabetes Association suggests that blood measurement of 3HB may improve the management of uncontrolled diabetes and reduce the burden of diabetic ketoacidosis (DKA).
Sick-Day Advice
Illnesses such as the common cold, urinary tract infections, and COVID-19 can cause glucose levels to rise in people with diabetes, potentially leading to serious conditions like DKA and hyperosmolar hyperglycemic state (HHS). It is crucial for individuals with diabetes to follow sick-day advice, which includes maintaining hydration, continuing insulin therapy, and monitoring blood glucose and ketone levels closely.
Diabetes and COVID-19
Severity and Duration of Illness
Diabetes has been identified as a significant risk factor for severe and prolonged illness in COVID-19 patients. A prospective study found that diabetic patients had more severe lung involvement and higher Computed Tomographic Severity Scores (CTSS) compared to non-diabetic patients, indicating a more serious and protracted course of illness. This underscores the importance of stringent management of diabetes during the COVID-19 pandemic to mitigate adverse outcomes.
Psychosocial Factors and Work Disability
Influence of Psychosocial Factors
Adverse psychosocial factors, such as living alone, psychological distress, job strain, and low support from supervisors, have been shown to increase the risk of work disability, including sickness absence and disability pension, among employees with diabetes. Addressing these psychosocial factors is essential to reduce work disability and improve the overall well-being of diabetic employees.
Conclusion
Diabetes significantly impacts sickness absence, with diabetic employees experiencing higher rates and longer durations of absence compared to non-diabetic employees. Effective management of diabetes, including sick-day protocols and addressing psychosocial factors, is crucial to minimize sickness absence and improve health outcomes. Additionally, the severity of illnesses like COVID-19 is exacerbated in diabetic patients, highlighting the need for vigilant diabetes management during such times.
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