Diabetes and work participation at older ages: evidence from the HEAF cohort

Objective: To examine associations between diabetes and work participation in adults aged 50–64 years, by treatment regimen. Methods: Diabetes of all types was ascertained through Clinical Practice Research Datalink linkage in the Health and Employment After Fifty cohort and categorised by treatment (no glucose-lowering medication, oral medication, insulin). Health-related job loss (HRJL) and prolonged sickness absence over nine years were examined among 4,813 employed adults using mixed-effects logistic regression. Results: Compared with no diabetes, diabetes treated with oral glucose-lowering medication (OR 1.89, 95%CI 1.26–2.82) and insulin (OR 3.07, 95%CI 1.83–5.15) was associated with HRJL. No treatment category was associated with prolonged sickness absence. Conclusions: Diabetes at older ages is associated with HRJL, most strongly among those on insulin. Treatment regimen likely marks disease severity and self-management burden rather than itself increasing risk.