title: Diabetes and employment productivity: does diabetes management matter?
abstract: OBJECTIVE
  To determine whether labor market effects were the result of diabetes per se or rather depended on the degree to which diabetes was controlled through management of blood sugar levels.
  
  
  METHODS
  This study utilized data from a recently completed survey of households in Brownsville, Texas, a largely Mexican American community with a high prevalence of diabetes that is located on the Texas-Mexico border. Diabetes management, or control, was measured by blood sugar levels, glycosylated hemoglobin (A1C) levels, and interaction terms. Methods used were probit and Heckman regression.
  
  
  RESULTS
  Management of diabetes did not appear to have a discernible impact on labor market outcomes in the short run. However, diabetes was negatively associated with male productivity, particularly in males' propensity to work. The new American Diabetes Association (ADA) definition of diabetes is based on having an A1C level of <6.5%. Using the new ADA definition, diabetes was negatively associated with female productivity. Female productivity was also negatively associated with the new ADA definition of prediabetes (A1C levels between 5.7% and 6.4%). However, very few people with diabetes actually controlled their blood sugar or A1C levels.
  
  
  CONCLUSIONS
  These results imply that in order to avoid productivity losses associated with diabetes, more scarce prevention resources should be spent on prevention of the onset of diabetes than on the management of A1C for those already diagnosed with diabetes. For women, the prevention of prediabetes is key.
authors.affiliation: Division of Management, Policy and Community Health, Michael and Susan Dell Center for Advancement of Healthy Living Institute for Health Policy, University of Texas School of Public Health-Austin Campus, USA. henry.s.brown@uth.tmc.edu
authors.forename: H Shelton
authors.initials: HS
authors.lastname: Brown I I I
authors.forename: Adriana
authors.initials: A
authors.lastname: Perez
authors.forename: Lisa Marie
authors.initials: LM
authors.lastname: Yarnell
authors.forename: Jose A
authors.initials: JA
authors.lastname: Pagan
authors.forename: Craig L
authors.initials: CL
authors.lastname: Hanis
authors.forename: Susan P
authors.initials: SP
authors.lastname: Fischer-Hoch
authors.forename: Joseph B
authors.initials: JB
authors.lastname: McCormick
mesh_terms: D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000208:ethnology; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D017058:Mexican Americans; D013781:Texas / Q000453:epidemiology