The aim of this review article was to discuss impact of diabetic foot ulcers (DFUs) on employment status and work productivity. We performed a literature search from 2000 to 2023 in PubMed, Scopus, Google Scholar and in national repositories. The major work outcomes studied were presenteeism and absenteeism. Many DFUs patients had a poor social and educational background. Overall, DFUs patients experienced increased loss of productivity in their workplaces: either they had to be absent more working hours than average or they faced increased difficulty in meeting their daily requirements. The total loss in productivity is estimated to exceed almost one-third of anticipated working time, while 15 to 34.3% of DFUs patients expressed concerns about severe changes in their working environment, attributed directly to their condition. More than 1 out of 5 DFUs patients (ranging from 20 to 31.7%) were even confronted with overall job loss and unemployment. Amputations had an even more marked negative effect. In conclusion, DFUs negatively affect employment status and work productivity. Therefore, we need more studies with large participant numbers to increase our experience and to explore potential measures to mitigate these adverse effects.
McDermottKFangMBoultonAJMSelvinEHicksCW. Etiology, epidemiology, and disparities in the burden of diabetic foot ulcers. Diabetes Care. 2023;46(1):209-221.
2.
RodriguesBTVangavetiVNUrkudeRBirosEMalabuUH. Prevalence and risk factors of lower limb amputations in patients with diabetic foot ulcers: A systematic review and meta-analysis. Diabetes Metab Syndr. 2022;16(2):102397.
3.
ZhangPLuJJingYTangSZhuDBiY. Global epidemiology of diabetic foot ulceration: A systematic review and meta-analysis. Ann Med. 2017;49(2):106-116.
4.
ChenLSunSGaoYRanX. Global mortality of diabetic foot ulcer: A systematic review and meta-analysis of observational studies. Diabetes ObesMetab. 2023;25(1):36-45.
5.
CrockerRMPalmerKNBMarreroDGTanTW. Patient perspectives on the physical, psycho-social, and financial impacts of diabetic foot ulceration and amputation. J Diabetes Complications. 2021;35(8):107960.
6.
TanTWArmstrongDGKCCM, et al.Association between race/ethnicity and the risk of amputation of lower extremities among medicare beneficiaries with diabetic foot ulcers and diabetic foot infections. BMJ Open Diabetes Res Care. 2020;8(1):e001328.
7.
TanTWShihCDConcha-MooreKC, et al.Disparities in outcomes of patients admitted with diabetic foot infections. PLoS One. 2019;14(2):e0211481.
8.
SorberRAbularrageCJ. Diabetic foot ulcers: Epidemiology and the role of multidisciplinary care teams. Semin Vasc Surg. 2021;34(1):47-53.
9.
HexNBartlettCWrightDTaylorMVarleyD. Estimating the current and future costs of type 1 and type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs. Diabet Med. 2012;29(7):855-862.
10.
BargFKCronholmPFEasleyEE, et al.A qualitative study of the experience of lower extremity wounds and amputations among people with diabetes in Philadelphia. Wound Repair Regen. 2017;25(5):864-870.
11.
PalmerKNBCrockerRMMarreroDGTanTW. A vicious cycle: Employment challenges associated with diabetes foot ulcers in an economically marginalized southwest US sample. Front Clin Diabetes Healthc. 2023;4:1027578.
12.
Selçuk TosunAAkgül GündoğduNTaşFAteşS. Experiences, thoughts, and feelings of patients with a diabetic foot ulcer in Turkey: A qualitative descriptive study. J VascNurs. 2022;40(3):140-147.
13.
CabeceiraHDSSouzaDMSTJulianoYVeigaDF. Work ability and productivity in patients with diabetic foot. Clinics (Sao Paulo). 2019;74:e421.
14.
RiceJBDesaiUCummingsAKBirnbaumHGSkornickiMParsonsNB. Burden of diabetic foot ulcers for medicare and private insurers. Diabetes Care. 2014;37(3):651-658.
15.
FejfarováVJirkovskáADragomireckáE, et al.Does the diabetic foot have a significant impact on selected psychological or social characteristics of patients with diabetes mellitus?J Diabetes Res. 2014;2014:371938.
16.
ZalewskaUMaciochTSobolEMrozikiewicz-RakowskaBKrakowieckiAHermanowskiT. Absenteeism and presenteeism in a population of patients with diabetic foot ulcers in Poland. Value Health. 2014;17(7):A351.
17.
MaciochTZalewskaUSobolE, et al.The indirect costs of diabetic foot ulcers in Poland. J Diabetes Metab. 2015;6:540.
18.
Rodriguez-SanchezBAlessieRJMFeenstraTLAngeliniV. The relationship between diabetes, diabetes-related complications and productive activities among older Europeans. Eur J Health Econ. 2018;19(5):719-734.
19.
RibuLHanestadBRMoumTBirkelandKRustoenT. A comparison of the health-related quality of life in patients with diabetic foot ulcers, with a diabetes group and a nondiabetes group from the general population. Qual Life Res. 2007;16(2):179-189.
20.
WatersNHollowayS. Personal perceptions of the impact of diabeticfoot disease on employment. Diabetic Foot Journal. 2013;12:118-130.
21.
TejaswiYLAngadiN. The impact of diabetic foot ulcer on health related quality of life and employment among diabetics attending tertiary care teaching hospital, Davangere. Natl J Community Med. 2018;9(11):794-797.
22.
PerssonSJohansenPAnderssonE, et al.Days absent from work as a result of complications associated with type 2 diabetes: Evidence from 20 years of linked national registry data in Sweden. Diabetes ObesMetab. 2020;22(9):1586-1597.
23.
Lerner 1DAmick 3rdBCRogersWHMalspeisSBungayKCynnD. The work limitations questionnaire. MedCare. 2001;39(1):72-85.
24.
CiconelliRMSoárezPCKowalskiCCFerrazMB. The Brazilian Portuguese version of the work productivity and activity impairment: General health (WPAI-GH). questionnaire Sao Paulo Med J. 2006;124(6):325-332.
25.
Abbasi-GhahramanlooASoltani-KermanshahiMMansoriK, et al.Comparison of SF-36 and WHOQoL-BREF in measuring quality of life in patients with type 2 diabetes. Int J Gen Med. 2020;13:497-506.
26.
JenkinsonCCoulterAWrightL. Short form 36 (SF36) health survey questionnaire: Normative data for adults of working age. Br Med J. 1993;306(6890):1437-1440.
27.
JohnsG. Presenteeism in the workplace: A review and research agenda. J Organiz Behav. 2010;31:519-542.
28.
JacobsenDIFjeldeV. Part-time work and sickness absence - an organization-level analysis. BMC Public Health. 2023;23(1):2247.
29.
LavigneJEPhelpsCEMushlinALednarWM. Reductions in individual work productivity associated with type 2 diabetes mellitus. Pharmacoeconomics. 2003;21(15):1123-1134.
30.
NgYCJacobsPJohnsonJA. Productivity losses associated with diabetes in the US. Diabetes Care. 2001;24(2):257-261.
31.
KorffVKatonMLinW, et al.Work disability among individuals with diabetes. Diabetes Care. 2005;28(6):1326-1332.
32.
CooperOAETaylorDJCrabbDPSimDAMcBainH. Psychological, social and everyday visual impact of diabetic macular oedema and diabetic retinopathy: A systematic review. Diabet Med. 2020;37(6):924-933.
33.
StewartWFRicciJACheeEHirschAGBrandenburgNA. Lost productive time and costs due to diabetes and diabetic neuropathic pain in the US workforce. J Occup Environ Med. 2007;49(6):672-679.
34.
BrodMPohlmanBBlumSIRamasamyACarsonR. Burden of illness of diabetic peripheral neuropathic pain: A qualitative study. Patient. 2015;8(4):339-348.
35.
daCosta DiBonaventuraMCappelleriJCJoshiAV. A longitudinal assessment of painful diabetic peripheral neuropathy on health status, productivity, and health care utilization and cost. Pain Med. 2011;12(1):118-126.
36.
DiBonaventuraMDCappelleriJCJoshiAV. Association between pain severity and health care resource use, health status, productivity and related costs in painful diabetic peripheral neuropathy patients. Pain Med. 2011;12(5):799-807.
