title: Trends of diagnosis-specific work disability after newly diagnosed diabetes: a 4-year nationwide prospective cohort study.
abstract: OBJECTIVE
  We examined trends of diagnosis-specific work disability after newly diagnosed diabetes, comparing individuals with diabetes with those without diabetes, and identified the subgroups with the highest levels of work disability.
  
  
  METHODS
  The register data of diabetes medication and in- and outpatient hospital visits were used to identify all recorded new diabetes cases among the population aged 25-59 years in Sweden in 2006 (n = 14,098). Data for a 4-year follow-up of ICD-10 physician-certified sickness absence and disability pension days (2007‒2010) were obtained from the Swedish Social Insurance Agency. Comparisons were made using a random sample of the population without recorded diabetes (n = 39,056).
  
  
  RESULTS
  The most common causes of work disability were mental and musculoskeletal disorders; diabetes as a reason for disability was rare. Most of the excess work disability among people with diabetes compared with those without diabetes was owing to mental disorders (mean difference adjusted for confounding factors 18.8‒19.8 compensated days/year), musculoskeletal diseases (12.1‒12.8 days/year), circulatory diseases (5.9‒6.5 days/year), diseases of the nervous system (1.8‒2.0 days/year), and injuries (1.0‒1.2 days/year). The disparity in mental disorders first widened and then narrowed, while the difference in other major diagnostic categories was stable over 4 years. The highest rate (45.3 days/year) was found among people who had diabetes, lived alone, and were disabled from work owing to mental disorders.
  
  
  CONCLUSIONS
  The increased risk of work disability among those with diabetes is largely attributed to comorbid mental, musculoskeletal, and circulatory diseases. It is important to monitor comorbid conditions and take account of socioeconomic disadvantage.
authors.affiliation: Finnish Institute of Occupational Health, Helsinki and Turku, Finland marianna.virtanen@ttl.fi.
authors.forename: Marianna
authors.initials: M
authors.lastname: Virtanen
authors.affiliation: Finnish Institute of Occupational Health, Helsinki and Turku, Finland.
authors.forename: Jenni
authors.initials: J
authors.lastname: Ervasti
authors.affiliation: Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Ellenor
authors.initials: E
authors.lastname: Mittendorfer-Rutz
authors.affiliation: Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Petter
authors.initials: P
authors.lastname: Tinghög
authors.affiliation: Finnish Institute of Occupational Health, Helsinki and Turku, Finland Faculty of Medicine, University of Helsinki, Helsinki, Finland.
authors.forename: Tea
authors.initials: T
authors.lastname: Lallukka
authors.affiliation: Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Linnea
authors.initials: L
authors.lastname: Kjeldgård
authors.affiliation: Finnish Institute of Occupational Health, Helsinki and Turku, Finland.
authors.forename: Jaana
authors.initials: J
authors.lastname: Pentti
authors.affiliation: Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Alexanderson
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology*; D010415:Pensions / Q000706:statistics & numerical data; D018582:Sick Leave / Q000706:statistics & numerical data; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors