Diabetes reduces people's employment chances and wages around the world - according to a new study from the University of East Anglia, supported by the Centre for Diet and Activity Research (CEDAR).
Researchers studied the economic impact of type II diabetes worldwide.
They were surprised to find not only a large cost burden in high-income countries, but also in low and middle-income countries - where people with diabetes and their families face high costs for treatment.
While it is widely known that diabetes poses a huge health challenge, awareness of its impact on the global economy and labour markets has never before been studied in such detail.
The research team looked at data from 109 studies in the largest and most up-to-date global review of the economic impact of diabetes.
- People with diabetes in the US have the highest healthcare costs - with an estimated lifetime cost of around $283,000. These costs are higher than in others countries with comparable per capita income levels.
- Worldwide, diabetes hits the poor hardest - with a higher cost burden for people in low and middle income countries.
- Two thirds of all new cases of diabetes are now in low and middle income countries such as China, India, Mexico, and Egypt.
- Men with diabetes have worse employment opportunities globally. The impact for women appears to be less adverse - except for in the US, where their employment chances decreased by almost half.
- The costs associated with diabetes increase over time with disease severity.
Lead researcher Till Seuring, from UEA's Norwich Medical School said: "Diabetes affects 382 million people worldwide, and that number is expected to grow to 592 million by 2035. It is a chronic disease that has spread widely in recent decades - not only in high-income countries, but also in many populous low and middle-income countries such as India and China.
"The rising prevalence of diabetes in these countries has been fuelled by rapid urbanization, changing eating habits, and increasingly sedentary lifestyles."
The review provides detailed information about both direct costs of the disease, such as doctor and hospital visits, medication, lab costs for tests, and equipment costs, as well as indirect costs such as income losses due to early retirement, and lost work hours due to illness.
"The characteristics of the economic burden vary from country to country depending on the health care system in place. In high income countries the burden often affects government or public health insurance budgets while in poorer countries a large part of the burden falls on the person with diabetes and their family due to very limited health insurance coverage.
"Our results show a considerable impact of diabetes in terms of costs to society, health systems, individuals and employers.
"This research provides a comprehensive picture of the economic impact of diabetes in poorer countries. The results show that people in these countries are the worst off because the economic burden on their livelihoods is much greater.
"Our findings underline the fact that diabetes not only has strong adverse effects on people's health but also presents a large - and at least partly avoidable - economic burden.
"We also found that the economic burden of diabetes increases over time. So early investments into prevention and disease management may therefore be particularly worthwhile.
"For both rich and poor countries, the results mean that better prevention and management of diabetes has the potential to not only bring good health but also economic gains.
"We would hope that the findings further increase the policy attention being paid to diabetes prevention and management in rich countries and it should in particular make health and economic policymakers in developing countries aware of the economic damage that diabetes can do."