Accumulated exposure to unemployment is related to impaired glucose metabolism in middle-aged men:a follow-up of the Northern Finland Birth Cohort 1966

Abstract Aims: We explored whether registered unemployment is associated with impaired glucose metabolism in general population. Methods: Based on Northern Finland Birth Cohort 1966 at 46 years, we analyzed the oral glucose tolerance tests of 1970 men and 2544 women in relation to their preceding three-year employment records in three categories of unemployment exposure: no (employed), low (≤1-year) and high exposure (>1-year). Results: Among men, pre-diabetes was found in 19.2% of those with no unemployment, 23.0% with low and 27.0% with high exposure, the corresponding figures for screen-detected type 2 diabetes were 3.8%, 3.8% and 9.2% (p < 0.01). Among women, analogous figures for pre-diabetes were 10.0%, 12.6% and 16.2% and for screen-detected type 2 diabetes 1.7%, 3.4% and 3.6% (p < 0.01). Men with high exposure to unemployment had a higher risk for pre-diabetes (OR 1.61, CI 95% 1.03–2.51) and screen-detected type 2 diabetes (OR 2.58 95% CI 1.23–5.44) than employed men, after adjustment for education, smoking, alcohol intake, physical activity and body mass index. Among women, associations were attenuated in the adjusted models. Conclusions: High exposure to unemployment may predispose to type 2 diabetes in middle-aged men. For clinicians, awareness of the patient’s unemployment status may be helpful in recognizing undiagnosed cases