- High prevalence of presenteeism in young-onset diabetes, linked to diabetes-related emotional burden and reduced health-related quality of life.
- Multidimensional barriers span interpersonal, workplace and societal domains, including psychological distress, family collectivism, inflexible schedules, absence stigma and out-of-pocket costs.
- Reducing presenteeism requires holistic, person-centred strategies: public awareness, early diagnosis and genetic testing, peer support, treatment autonomy and insurance coverage.
Diabetes Obes Metab. 2026 Aug 26. doi: 10.1111/dom.71158. Online ahead of print.
ABSTRACT
AIMS: Young-onset non-type 1 diabetes (YOD, age-at-diagnosis ≤ 40) is associated with poor physical and mental health, presenteeism and productivity loss. We examined patient-perceived barriers to work productivity and key enablers to reduce presenteeism.
MATERIALS AND METHODS: In this mixed-methods study, we utilized validated questionnaires to measure presenteeism (World Health Organization Health and Performance Questionnaire); self-care activities (Summary of Diabetes Self-Care Activities; Compliance Questionnaire for Medication); health-related quality of life (HRQoL, EQ-5D-3L) and psychological distress (Depression Anxiety Stress Scale; Chinese Diabetes Distress Scale) among participants with YOD in the Precision Medicine to Redefine Insulin Secretion and Monogenic Diabetes-Randomised Controlled Trial (PRISM-RCT). We conducted four semi-structured focus group discussions (FGDs) for inductive thematic analysis.
RESULTS: Employees with YOD (n = 465, mean age: 43.4 ± 6.4 years, disease duration: 10.9 ± 6.0 years, 59.8% male) had better cardiometabolic, psychological and HRQoL profiles than non-employees (n = 103). Among the employees, 67.4% had at least one sickness presenteeism episode in the preceding year, with a mean presenteeism score of 7.1 ± 1.6 (out of 10). Increased presenteeism was independently associated with diabetes-related emotional burden (β = -0.07, p = 0.049) and suboptimal HRQoL (β = 3.36, p = 0.037). Participants of FGDs (n = 16) reported distress contributors related to inter-personal (psychological/physical status, family collectivism), work (schedules/types, absence justification, colleagues’ attitudes) and societal factors (relationships with providers, out-of-pocket payment, stigmatisation). Enablers included public awareness, early diagnosis (genetic testing for offspring, regular health-check), peer support, treatment choices autonomy and insurance coverage.
CONCLUSION: In YOD, presenteeism is associated with interpersonal, work and societal factors accompanied by psychological distress, suboptimal diabetes care, self-management challenges, calling for holistic assessment and person-centred management.
PMID:42649103 | DOI:10.1111/dom.71158
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