2 diabetes studies in Jan. 2014 Health Affairs

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Health Affairs
2 diabetes studies in Jan. 2014 Health Affairs Jan. articles examine the toll of diabetes, both in the US and abroad Poorer Americans: depleted food budgets can mean higher risk of hypoglycemia.

For generations, economists have noted that low-income households spend much of their earnings as soon as their paychecks arrive. Since a large proportion of Americans are paid at the beginning of the month, many low-income households exhaust food budgets by month's end.

Hilary K. Seligman of the University of California, San Francisco, and coauthors, postulated that this could influence health outcomes, such as heightened risk for low blood sugar (hypoglycemia) among people with diabetes.

The authors examined administrative data on inpatient admissions in California for 2000-08 and found that among low-income Californians, risk for hypoglycemia admission increased 27 percent in the last week of a month compared to the first week of the month; no similar temporal pattern existed for the high-income population. The authors conclude that exhausted food budgets late in the month might also influence admission patterns for other diet-sensitive diseases, such as congestive heart failure. This is one of the first studies (perhaps the very first) to study the link between exhausted food budgets and disease increase at the end of the month.

Diabetes and the workforce: in sixteen countries, the disease causes earlier retirement.

The economic burden of diabetes and the effects of the disease on the labor force are of substantial importance to policy makers.

Juliet Rumball-Smith of the University of Toronto, and coauthors, examined the impact of diabetes on leaving the workforce using data about people fifty and older from sixteen countries between 2002 and 2007. (The countries surveyed: the US, England, Austria, Belgium, the Czech Republic, Denmark, France, Germany, Greece, Ireland, Italy, the Netherlands, Poland, Spain, Sweden, and Switzerland.) Across the sixteen countries, workers diagnosed with diabetes had a 30 percent increase in the rate of labor-force exit, compared to those without the disease. The authors concluded that these finding further support the value of greater public- and private- sector investment in preventing and managing diabetes.

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