Issue 134 Item 3 Employees Who Control Their Blood Glucose Are More Productive

Studies show that those who control their BG earn $1700 more Two studies have looked specifically at the effect of glycemic control and diabetes interventions for employees. A 12-week double-blind study (Testa et al., 1998) of 569 individuals who had type 2 diabetes found that those who improved their glycemic (blood sugar) control

Were more productive on the job (99% versus 87%) and able to remain employed longer (97% versus 85%) than employees who did not control and lower their blood sugar levels.

Lowered their absenteeism rate by 1% compared with an 8% increase in employees with poor glycemic control. Lost earnings due to absenteeism were estimated at only $24 per worker per month for male employees who improved their glycemic control in comparison with $115 for those with uncontrolled blood sugar.

Had fewer days of restricted activity and bed rest than those who did not improve their glycemic control. Lost earnings due to restricted activity was $2,660 per 1,000 person-days for male employees with good glycemic control versus $4,275 for those with poor control. For those restricted to bed rest, lost earnings were $1,539 per 1,000 person-days for male employees compared with $1,843 for those with poor glycemic control.

Another study (Burton et al., 1998), performed at the First Chicago NBD Corporation, found that after 3 months of attending a worksite diabetes education program, employees with diabetes had

Lowered their mean fasting blood sugar from 198 mg/dL to 180 mg/dL.

Reduced their mean hemoglobin A1c from 9.0% to 8.3%. The hemoglobin A1c test indicates average blood sugar control over a 90-day period and is essential for monitoring blood glucose control.

Although the values in this study were still higher than the ideal blood sugar range, any improvement in glycemic control has been shown to reduce the risk for diabetes-related complications.

A third recent study, conducted by Health Partners, a nonprofit HMO, looked at the inpatient and outpatient cost of its members who had diabetes (Gilmer et al., 1997). The researchers found that those with higher hemoglobin A1c values had higher medical costs over a 3-year period. Expenses were significantly higher for each percentage point increase above a hemoglobin A1c of 7%. For example, the medical costs of a person with a hemoglobin A1c of 9% might average $2,000 more than those for a person with a hemoglobin A1c of 8%. Costs were found to be even higher if the person also had heart disease and high blood pressure.

Please note that the Health Partners study did not demonstrate that lowering glucose levels by the amounts in the study would reduce costs. The program costs to lower glucose levels are also not taken into account. Rather, it showed an association between baseline glycemic control and subsequent health care costs.