Retirement due to disabilities in patients with type 1 diabetes a nationwide multicenter survey in BrazilReportar como inadecuado

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BMC Public Health

, 15:486

Chronic Disease epidemiology


BackgroundThere is scarcity of data concerning retirement and workforce loss exclusively in patients with type 1 diabetes. The aim of this study was to evaluate the prevalence, causes, and predictors of retirement in patients with type 1 diabetes in Brazil.

MethodsThis was a multicenter cross-sectional study conducted between December 2008 and December 2010 in 28 public clinics in 20 Brazilian cities. Data were obtained from 3,180 patients aged 22 ± 11.7 years; 56.3% of the participants were female, and 57.4% were Caucasians. The mean time since diabetes diagnosis was 10.3 ± 8.1 years. Patients’ information clinical factors and retirement data was obtained through a questionnaire and a chart review. Patients were retired by diabetes according to the Brazilian Institute of Social Security’s criteria that takes in account the presence of diabetes-related chronic complications certified by a doctor, excluding any personal reason or another health condition besides diabetes. Both quantitative and qualitative tests were employed, and a multivariate logistic regression model was performed to identify the factors associated with retirement due to disabilities in patients with type 1 diabetes.

ResultsThe overall frequency of retirement was 4.2%, with no difference between genders. The mean age of retirement was 35.5 ± 9.3 years, resulting in 17.5 ± 9.1 years of workforce losses. These patients had a significantly higher prevalence of severe hypoglycemia, proliferative and non-proliferative retinopathy, foot disorders, chronic or end-stage renal disease requiring dialysis or transplantation, cataracts, glaucoma, psychological disorders, hypertension, and overweight-obesity than did the employed patients. Multivariate logistic regression analysis with retirement as the dependent variable showed adjusted odds ratios ORs of 4.87 2.66-8.78 for the presence of microvascular complications and 3.7 2.04-6.70 for macrovascular complications.

ConclusionsRetirement due to disabilities occurred in 4.2% of Brazilian patients with type 1 diabetes at an early age and is strongly associated with diabetes-related chronic complications. Health care workers should thus reevaluate the quality of care given to these patients.

KeywordsType 1 diabetes Chronic complications Early retirement Disabilities AbbreviationsT1DType 1 diabetes

ADAAmerican Diabetes Association

HRSHealth and Retirement Study

GAZELThe GAZ and Électricité cohort study

NHISNational Health Interview Survey

BrazDiab1SGBrazilian Type 1 Diabetes Study Group

BNHCSBrazilian National Health Care System

BISSBrazilian Institute of Social Security

HbA1Cglycated hemoglobin

NGSPNational Glycohemoglobin Standardization Program

FBGFasting blood glucose

BDSBrazilian Diabetes Society

sBPSystolic blood pressure

dBPDiastolic blood pressure

BMIBody mass index

HDLHigh-density lipoprotein

LDLLow-density lipoprotein

SBGMSelf-blood glucose monitoring

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Autor: Marilia Brito Gomes - Carlos Antonio Negrato - On behalf of the Brazilian Type 1 Diabetes Study Group BrazDiab1SG


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