Impaired hypoglycaemia awareness and employment in people with Type 1 diabetes

Impaired awareness of hypoglycaemia (IAH) is common in adults with Type 1 diabetes mellitus (T1DM) and is a major risk factor for severe hypoglycaemia. Little is known about its effect on employment status.

To examine the effect that IAH has on the employment status or employability of people with T1DM.

A randomly selected cohort of adults of employment age with T1DM completed a questionnaire detailing the history of their diabetes, their occupational history (including job and industry type) and assessing both their hypoglycaemia awareness status and whether in their view their ability to obtain or retain employment had been adversely affected by having diabetes.

A total of 252 patients participated, with the following characteristics: 135 males, mean HbA1c 8.5% [standard deviation (SD) 1.4], mean age 43.3 years (SD 13.2), mean duration of diabetes 21.3 years (SD 12.8) and prevalence of IAH 23.4%. The employment rate was comparable between those with preserved awareness (73%) and the IAH group (66%) (not significant). People with IAH were older (P < 0.05) and also more commonly felt that having diabetes affected their ability to work (P < 0.05).

This study is the first to demonstrate that those with T1DM and IAH remain as economically active as those with normal awareness of hypoglycaemia, although subjects with IAH were significantly more likely to feel that having diabetes had adversely affected their capacity for employment.