Retirement due to disabilities in patients with type 1 diabetes a nationwide multicenter survey in Brazil

BMC Public Health

Research Article

Carlos Antonio Negrato¹  Marilia Brito Gomes² 

[1] Bauru’s Diabetics Association, Bauru, São Paulo, Brazil;Department of Internal Medicine, Diabetes Unit, State University of Rio de Janeiro, Rio de Janeiro, Brazil;

关键词: Type 1 diabetes;    Chronic complications;    Early retirement;    Disabilities;   

DOI  :  10.1186/s12889-015-1812-4

 received in 2014-10-16, accepted in 2015-04-29,  发布年份 2015

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY   
© Gomes and Negrato; licensee BioMed Central. 2015